A Bilobed Schwannoma in Roof of Orbit: A Rare Case Report

Abstract

In this paper, we report a case of bilobed schwannoma, presented in the roof of orbit arising from supraorbital nerve. A 62-year male presented with a nontender mass in superior part of orbit and eccentric proptosis. Visual acuity and rest of ocular examination were normal. CT scan and MRI orbit revealed an extraconal homogenous bilobed mass, of size 3.5 to 2.5 cms in roof of orbit. Fine needle aspiration cytology was done, which was suggestive of schwannoma a peripheral nerve tumor. Successful surgical excision of intact bilobed schwannoma was done with careful separation and preservation of supraorbital nerve from which it was originated. Postoperative period was uneventful though rare, less than 1%, schwannoma can present as painless mass in the orbit and proptosis. Treatment of choice is surgical excision of intact tumor to prevent recurrence and preservation of peripheral nerve from which it arises.

Cystic Schwannoma Arising from Supraorbital Nerve Masquerading as a Dermoid: An Unusual Case

“…Study conducted by Singh M., et al found that 69% of the orbital schwannoma were unilateral with preponderance for the right orbit [12], which correlates with our report. Garg R., et al and Dulani S., et al found that these orbital tumors were slow growing in nature and was not associated with any pain, globe displacement, ocular immobility or dimension of vision, which was also seen in our case report [4,6]. However, Subramanian N., et al found proptosis and decreased in vision in their four cases of orbital schwannoma with cystic degeneration as these tumors present as intraconal mass in the orbit [5].…”

“…Schwannomas of orbit are one of the rare tumors and they are also seen in association with neurofibromatosis in around 2% -18% of the cases [6]. These tumors are usually encapsulated and non invasive in nature and has minimum effect on orbital structure [7,8].…”

Supraorbital nerve schwannoma in a young Chinese man: a case report and review of the literature

“…1 They usually originate from the ophthalmic division of the sensory branch of the trigeminal nerve, most commonly the supraorbital and supratrochlear nerves. 2 We report an anterior orbitotomy through an upper eyelid crease incision approach for resection of a supraorbital nerve schwannoma.…”