|Year : 1962 | Volume
| Issue : 2 | Page : 45-46
Neurilemmoma of the orbit - a case report
P Ramchander, OM Satyendran
Sarojini Devi Hospital and Institute of Ophthalmology and Otolaryngology, Hyderabad, India
|Date of Web Publication||29-Mar-2008|
Sarojini Devi Hospital and Institute of Ophthalmology and Otolaryngology, Hyderabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ramchander P, Satyendran O M. Neurilemmoma of the orbit - a case report. Indian J Ophthalmol 1962;10:45-6
Neurilemmoma or Schwann cell tumour occurs at any age, females being more liable than males. It arises from the intracranial nerves or from the peripheral nerves and is usually solitary. A neurilemmoma of the orbit is rare (Duke-Elder, 1955).
It is rounded or ovoid, encapsulated and well circumscribed and has an eccentric position with regard to its nerve of origin. The nerve of origin may be seen as a thin thread. Its consistency may be firm and solid or cystic and fluctuant. Microscopically they are of two types. In type A, parallel cells and fibres form interwoven bundles, the rows of parallel cells being separated by nucleus free zones of densely aggregated fibres. The regimentation of its cells is the only characteristic feature of a neurilemmoma (Willis, 1953).
In type B, the cells are arranged in a loose meshwork. Intercellular vacuoles or microcysts are usually present. The regimentation of the cells is not well marked.
Confusion exists in the use of the terms neurilemmoma and neurofibroma. Some apply the term neurofibroma to all benign tumours of the nerve sheath irrespective of whether they are associated with V. Recklinghausen's disease or not. Stout would like to abolish the name "neurofibroma" and substitute for it the term "diffuse neurilemmoma", Evans (1955) considers that the differences in their mode of origin, behaviour, and in their structure warrant their segregation under different headings.
Neurilemmoma is cured by local removal. Recurrences may occur where complete removal is not practicable. A malignant change is possible. (Willis 1953).
| Case Report|| |
The patient who was under treatment in July, '60, was a woman of forty-five years. She complained of protrusion of her right eye which has been increasing slowly during the past five years. It had become painful lately. [Figure - 1].
The clinial findings were an axial proptosis of the right eye, with restriction of movements of the eyeball in the directions especially laterally. The proptosis was nonpulsating and irreducible. A firm mass was palpable in the superolateral region of the orbit. Fundus examination showed a hyperemic optic disc and engorged veins. Skiagram did not reveal any abnormality and laboratory investigations offered no clue to the diagnosis. On exploration through lateral orbitotomy a rounded mass situated posterior and lateral to the globe was seen. This was removed complete. It was an encapsulated, ovoid smooth, firm mass 3.5 cm x 2.5 cm with a nerve coursing along one aspect of its surface. [Figure - 2].
The histological picture was that of a neurilemmoma exhibiting features of types A and B. [Figure - 3].
| References|| |
Duke Elder, (1955), Text book of ophthalmology, Vol. 5, P. 5580, Kimpton, London.
Evans, (1956), Histological Appearances of Tumours, P. 246, Livingstone, London.
Willis, (1953), Pathology of Tumours, P. 833 -
834, Butterworth, London.
[Figure - 1], [Figure - 2], [Figure - 3]