Extraconal cystic schwannoma mimicking an orbital dermoid cyst

Feijó, Eduardo Damous; Nery, Ana Carla de Souza; Caiado, Fábio Ramos; Prehis, Aline Maria; Limongi, Roberto Murillo

doi:10.5935/0004-2749.20160073

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Case Reports • Arq. Bras. Oftalmol. 79 (4) • Jul-Aug 2016 • https://doi.org/10.5935/0004-2749.20160073 copy

Extraconal cystic schwannoma mimicking an orbital dermoid cyst

Schwannoma cístico extraconal simulando um cisto dermóide orbitário

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

To our knowledge, we report the first case of an extraconal orbital cystic schwannoma in Brazilian literature. The tumor grew slowly and progressively and was associated with minimal eccentric proptosis and diplopia. The radiologic study (orbital computed tomography) revealed a rounded, encapsulated, and extraconal cystic mass in the superior medial region of the right orbit in the supraorbital and supratrochlear nerve topography. An anterior orbitotomy with full excision of the tumor was performed, and the histopathology examination revealed that the tumor was a schwannoma. After the surgery, the patient experienced total remission of his symptoms.

Keywords:
Neurilemmoma diagnosis; Neurilemmoma surgery; Orbital neoplasms; Exophthalmos; X-ray computed tomography

Author	Patient	Localization	CT findings	Pathologic findings
Imamura et al. 1986⁽⁶6 Imamura PM, Settanni FA, Stavale, JN. Neurilemoma oftálmico. Arq Bras Oftalmol. 1986;49(3):89-94.⁾	Male, 29 y	Intraconal	Solid lesion, intraconal space	Antoni A and B cells, benign tumor
Monteiro et al. 1994⁽⁷7 Monteiro ML, Marantes CR, Cunha SL. Schwannoma malígno da órbita associado a proptose e ectasia posterior do globo ocular. Arq Bras Oftalmol. 1994;57(6):400-2.⁾	Female, 68 y	Intraconal	Solid lesion, intraconal space	Antoni A and B cells, anaplasic cell figures, malignant tumor
Bison et al. 1996⁽⁸8 Bison SH, Vital Filho J, Cursino JW, Lancellotti CL. Schwannoma maligno de órbita. Arq Bras Oftalmol. 1996;59(6):608-10.⁾	Male, 39 y	Intraconal	Solid lesion, intraconal space	Antoni A and B cells, atypical mitotic figures, malignant tumor
Távora et al. 1999⁽⁹9 Távora DB, Monte FQ, Guedes Júnior EO. Evolução singular de um schwannoma maligno da órbita. Rev Bras Oftalmol. 1999:58(11):831-5.⁾	Male, 42 y	Extraconal, medially	Solid lesion, extraconal space	Antoni A and B cells, atypical mitotic figures, malignant tumor
Maciel et al. 2001⁽¹⁰10 Maciel VS, Marback EF, Sé DC, Marback RL. Neurilemoma benigno do nervo supraorbitário. Rev Bras Oftalmol. 2001;60(1):66-9.⁾	Male, 14 y	Supraorbital nerve topography	Solid lesion, supraorbital topography	Antoni A and B cells, benign tumor
Coutinho et al. 2014⁽¹¹11 Coutinho MS, Meyer I, Jungmann P, Souza Filho JP. Schwannoma em pálpebra superior esquerda em criança de 10 anos. Rev Bras Oftalmol. 2014;73(2):117-9.⁾	Female, 10 y	Upper eyelid	Solid lesion, upper eyelid	Antoni A predominant, benign tumor

Author	Patient	Localization	CT findings	Pathologic findings
Lam et al. 1997⁽²2 Lam DS, NG JS, To KF, Abdulah V, Liew CT, Tso MO. Cystic schwannoma of the orbit. Eye (Lond). 1997;11(Pt 6):798-800.⁾	Male, 52 y	Extraconal, paramedian	Large paramedian cystic lesion, extraconal	Antoni A and B cells, benign tumor
Tsuzuki et al. 2000⁽³3 Tsuzuki N, Katoh H, Ohnuki A, Ishihara S, Miyazawa T, Nawashiro H, Shima K. Cystic schwannoma of the orbit: case report. Surg Neurol. 2000;54(5):385-7.⁾	Female, 62 y	Intraconal	Cystic lesion	Antoni A predominant, benign tumor
Subramanian et al. 2005⁽⁵5 Subramanian N, Rambhatia S, Mahesh L, Menon SV et al. Cystic schwannoma of the orbit. Orbit. 2005 Jun;24(2):125-9.⁾	Female, 63 y	Intraconal	Intraconal mass with cystic spaces	Antoni A and B cells, benign tumor
Gündüz et al. 2011⁽⁴4 Gündüz K, Kurt RA, Erden E. Orbital schwannoma with fluid-fluid levels on MRI. Ophthal Plast Reconstr Surg. 2011;27(3):e51-4.⁾	Male, 40 y	Extraconal, orbit medial wall	Extraconal mass, bilobed, cystic	Antoni A predominant and Antoni B cells, benign tumor
Hayashi et al. 2012⁽¹1 Hayashi Y, Watanabe T, Kita D, Hayashi Y, Takahira M, Hamada J. Orbital cystics chwannoma originating from the frontal nerve. Case Rep Ophthalmol Med. 2012;2012:604574. doi: 10.1155/2012/604574. https://doi.org/10.1155/2012/604574... ⁾	Female, 65 y	Frontal nerve topography	Cystic lesion, extraconal, above levator muscle	Antoni A and B cells, benign tumor

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[1] Corresponding author: Eduardo D. Feijó. Av. Faiad Hanna, 235 - Anápolis, GO - 75080-410 - Brazil E-mail: eduardodff@yahoo.com.br