Neurogenic tumors of the orbit.

Fifty-three patients with neurogenic orbital tumors were diagnosed and treated at our university hospital during the past three decades. There were 16 patients with juvenile pilocytic astrocytomas, 21 patients with meningiomas and 16 with peripheral nerve tumors. Of the 16 peripheral nerve tumor patients, 8 had schwannoma, 4 had neurofibroma, 2 had malignant schwannoma, one had paraganglioma and one had amputation neuroma. Optic nerve tumors were treated via a transfrontal craniotomy if there was no chiasmal involvement. Cases with chiasmal involvement, incomplete resections and recurrences were treated with radiotherapy (5000 cGy). Far advanced cases with progressive proptosis and ocular damage underwent exenteration. Peripheral nerve tumors were treated by local resection. Exenteration was applied when there was an advanced or malignant lesion. Four of the 16 glioma patients and 5 of the 21 meningioma patients died during follow-up. The prognosis for peripheral nerve tumors was generally good, except for malignant schwannomas. Two patients with this malignant tumor died within 2 years after surgery.