Clinico-Radiological Spectrum and Management of Orbital Schwannomas: A Tertiary Care Institute Study

Abstract

Purpose: The aim is to study clinical presentations, radiological features and outcome in histopathologically proven orbital schwannomas.

Methods: A retrospective and longitudinal study of 16 patients between January 1999 and July 2011 was undertaken by reviewing the appropriate charts. Clinical and radiological data of all orbital schwannomas patients were analyzed.

Results: Mean age was 28.18 years (range 8–40 years). Of 16 patients, 10 were males and 6 females. Duration of symptoms was chronic in 15(93%). Chief complaints were proptosis in 10(62.5%), eyelid swelling in 5(31%) and eyelid mass lesion in 2(12.5%). This included a rare case of cystic schwannoma with microphthalmos. Mass was extraconal in 11(69%). Radiological findings varied from solid to cystic, intraconal to extraconal, no enhancement to intense enhancement and presence of calcification. Thirteen (81%) were excised via anterior orbitotomy route while fronto-orbital craniotomy was done in 3(19%). Postoperatively, vision improved or remained stable in 15(94%) and worsened in one (6%). Final visual acuity of 6/6 was achieved in 11(69%), 6/9 in 2, 6/36 in one.

Conclusions: Schwannomas may mimic a variety of mass lesions in the orbit because of variable clinical or imaging features and should be considered in the differential diagnosis of all well circumscribed orbital lesions.

• Orbital Schwannoma
• clinical presentation
• radiological features