Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern Califonrnia, Los Angeles, CA, USA.
Orbit. 2022 Feb;41(1):15-27. doi: 10.1080/01676830.2020.1858431. Epub 2021 Jan 4.
To present a case of orbital schwannoma and assess the literature on treatment modalities.
A MEDLINE literature search for cases of orbital schwannomas was performed using the PubMed search tool using the search terms "orbital schwannoma" and "orbital neurilemmoma." Papers were included if they were peer-reviewed, published in English, discussed management, and included the search terms. Each article was rated using the scale developed by the British Centre for Evidence-Based Medicine. In addition, we present a case report of an orbital schwannoma.
A total of 428 articles were found. 102 met the criteria for inclusion. Only two articles met Level 1 evidence and 16 were important to the clinical care process. We report a case of a biopsy-proven orbital schwannoma managed conservatively with observation over a 4-year period due to risk of cosmetic disfigurement with tumor removal. There has been no change in tumor size and no associated complications during follow up.
There is a paucity of data on the natural history of orbital schwannomas. Based on our review of the literature, we recommend observation for asymptomatic or minimally symptomatic orbital schwannomas with minimal growth over an extended period of time. For rapidly growing tumors or large tumors affecting key structures causing visual loss, diplopia, aesthetic disfigurement, or patient discomfort, a more aggressive approach may be necessary.
介绍一例眼眶神经鞘瘤病例，并评估治疗方法的文献。
使用 PubMed 搜索工具，以“眼眶神经鞘瘤”和“眼眶神经纤维瘤”为检索词，对 MEDLINE 文献进行检索，以获取眼眶神经鞘瘤的病例。如果文章为同行评议、以英文发表、讨论了治疗管理方法且包含检索词，则将其纳入。使用英国循证医学中心制定的量表对每篇文章进行评分。此外，我们还报告了一例眼眶神经鞘瘤病例。
共发现 428 篇文章，其中 102 篇符合纳入标准。仅有 2 篇文章符合 1 级证据标准，16 篇对临床护理过程很重要。我们报告了一例活检证实的眼眶神经鞘瘤病例，由于肿瘤切除可能导致美容缺陷，该患者因风险因素而保守观察，4 年来肿瘤大小无变化，也无相关并发症。
关于眼眶神经鞘瘤的自然病程数据很少。基于我们对文献的回顾，我们建议对无症状或症状轻微、生长缓慢且无明显生长的眼眶神经鞘瘤进行观察。对于快速生长的肿瘤或影响关键结构导致视力丧失、复视、美容缺陷或患者不适的大型肿瘤，可能需要更积极的治疗方法。
