Kim Kwang Seog, Jung Jin Woo, Yoon Kyung Chul, Kwon Yu Jin, Hwang Jae Ha, Lee Sam Yong
Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea.
Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea.
Arch Craniofac Surg. 2015 Aug;16(2):67-72. doi: 10.7181/acfs.2015.16.2.67. Epub 2015 Aug 11.
A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity.
A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence.
Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence.
Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.
施万细胞瘤是一种起源于施万细胞的良性、生长缓慢的周围神经鞘瘤。眼眶施万细胞瘤罕见,仅占所有眼眶肿瘤的1%。在本研究中,我们回顾性分析眼眶施万细胞瘤,并描述这种罕见疾病的临床、影像学和组织学特征。
进行回顾性分析,在2010年至2014年间因眼眶软组织肿块作为主要表现前来我院就诊的437例患者中,确定组织学确诊为眼眶施万细胞瘤的患者。查阅患者病历和医疗记录,获取人口统计学信息、相关病史和家族史、与眼及眼外感觉运动功能相关的体格检查结果、手术细节、术后并发症、病理报告及复发情况。
5例患者(5/437,1.1%)被确定为组织学确诊的眼眶施万细胞瘤并接受了完整切除。计算机断层扫描(CT)和磁共振成像(MRI)研究在预测组织学诊断方面并不一致。无并发症发生,所有患者均未出现明显瘢痕形成。2例患者术后出现前额轻度麻木,但在术后3个月内感觉完全恢复。5例患者均未复发。
眼眶施万细胞瘤是相对罕见的肿瘤。由于其表现和位置多变,术前诊断困难。通过CT或MRI对眼眶肿瘤进行适当的早期评估并及时处理,以防止严重并发症的发生。因此,在鉴别生长缓慢的眼眶肿块时应考虑眼眶施万细胞瘤。