Li T Y, Tong Q Z, Wang Y
Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China.
Zhonghua Yan Ke Za Zhi. 2022 Dec 11;58(12):1072-1074. doi: 10.3760/cma.j.cn112142-20220320-00128.
Patient 1 was a 44-year-old female with a progressively enlarging orbital mass on the right side for 2 years, while patient 2 was a 25-year-old female who complained of protrusion of the right eye for 2 months. Both patients presented with exophthalmos and a palpable infraorbital mass without vision loss. Magnetic resonance imaging examination showed a well circumscribed circular orbital lesion, with hypointensity on T1 weighted image and heterogeneous hyperintensity on T2 weighted image, which could be significantly enhanced, in either eye. Both eyes were diagnosed as begin orbital tumor and received resection under general anesthesia. Intraoperatively, the distal end of the tumors was found to transmigrate to normal nerves and insert into the inferior oblique muscle. Combined with the pathological diagnosis of schwannoma and postoperative occurrence of mydriasis and inferior oblique muscle paralysis in both patients, it was confirmed that the two lesions were schwannomas originating from the branch of the inferior oblique muscle innervated by the oculomotor nerve.
患者1是一名44岁女性,右侧眼眶肿物逐渐增大2年;患者2是一名25岁女性,主诉右眼突出2个月。两名患者均表现为眼球突出和可触及的眶下肿物,无视力丧失。磁共振成像检查显示,双眼均有一个边界清晰的圆形眼眶病变,T1加权像呈低信号,T2加权像呈不均匀高信号,可显著强化。双眼均被诊断为眼眶肿瘤,并在全身麻醉下接受了切除术。术中发现肿瘤远端迁移至正常神经并插入下斜肌。结合神经鞘瘤的病理诊断以及两名患者术后均出现瞳孔散大和下斜肌麻痹的情况,证实这两个病变均为起源于动眼神经支配的下斜肌分支的神经鞘瘤。