Optic nerve schwannoma

Case contributed by Dr Vijay Mistry

Presentation

Left proptosis and reduced vision

Patient Data

Age: 60 years
Gender: Male
CT

There is gross of left-sided proptosis with a low density intracoronal mass lesion within the left orbit. The optic nerve is stretched around the medial aspect of the lesion which is predominantly of low density measuring approximately 10 HU in density. The lesion measures 28 x 21 mm in axial plane, 20 mm craniocaudal. An enhancing component is seen in the inferior and medial margin. The lesion appears largely fluid filled, though the enhancing component is concerning for tumor.

MRI

Mixed solid and cystic intraconal mass in the left orbit with associated orbital proptosis.  The differential would include both benign and malignant lesions, however there is suggestion of bony remodelling reflecting a slow growing/longstanding process which is more supportive of the former. Other differentials would include nerve sheath tumor. Metastasis would be less likely given the interval stability.

Case Discussion

This patient presented with count-fingers vision in the left eye, after noticing reduced vision for over 1 year. The patient underwent left orbitotomy where the well-circumscribed nodule with a smooth and glistening lining measuring 30x25x15mm was successfully removed. Histopathology confirmed a benign schwannoma.

PlayAdd to Share

Case information

rID: 60621
Published: 28th May 2018
Last edited: 14th Aug 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.