|Year : 1977 | Volume
| Issue : 2 | Page : 42-44
Schwannoma of the orbit (a case report)
Arvind Kumar Sinha, AN Pandeya, RK Sharan
Patna Medical College Hospital, Patna, India
Arvind Kumar Sinha
Patna Medical College Hospital, Patna
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sinha AK, Pandeya A N, Sharan R K. Schwannoma of the orbit (a case report). Indian J Ophthalmol 1977;25:42-4
Orbit is an uncommon location for Schwannoma. Duke-Elder opines that Schwannoma of the orbit is so rare as to be a curiosity. Standel collected 8 cases of Schwannoma of orbit during 10 years among 68 cases of unilateral proptosis at Oslo. Mohan and Sen reported 4 cases of Neurilemmoma out of 54 cases of primary tumours of the orbit.
| Case Report|| |
K.K. 35, Muslim female was admitted in the Eye Department of Patna Medical College Hospital, Patna, with the history of forward bulging of right eye ball since 3 years [Figure - 1]. She gave a history of some operation done at Biharsharif about 3 years back. On examination. proptosis of right eye was evident. The anatomical structural details of the eye ball were obliterated, possibly due to the ill-conceived surgical intervention done 3 years earlier leading to complete loss of vision in the affected eye. On palpation, a non tender and irregularly round mass of firm consistency was felt more at the lower and outer angle of right orbit. Regional lymphnodes were not palpable. The left eve showed no departure from the normal. Complete blood count and urine examination did not reveal any abnormality. X-ray showed expansion of right bony orbital cavity. Partial exenteration of right orbit was done under general anaesthesia and the orbital contents were subjected for histopathological examination. Macroscopically, the mass consisted of a lacerated eyeball with consequent loss of morphological configuration [Figure - 2].
The almost ound tumour mass appeareder capsulated and measured 5 cms. x 3.8 cms. The consistency was variable. At one aspect, the white mass was rimmed by dark brown structure of some thickness. On section, the interior was occupied by small cystic areas interspersed by solid looking homogenous surlaces. Microscopically, the sections showed a partially encapsulated tumour characterised by several criss-crossing fascicles. At other places there were linear palisading of the nuclei. Areas of cystic degeneration with loosely textured tissue around further characterised the tumour. In short, there was an assemblage of structures characterising Antony type A and B histological features. Areas of chronic inflammatory reactions and haemorrhages were seen focally. None of the sections revealed evidences of malignant changes [Figure - 3][Figure - 4]. Diagnosis of Schwannoma right orbitwas made.
| Discussion|| |
Schwannoma is a widely accepted term to denote a localised, encapsulated, benign nerve sheath tumour occuring any where along the course of a peripheral, cranial or sympathetic nerve. It may occur at any age or in either sex. It is as a rule solitary and grows very slowly with sometimes long period of intermittency lasting several years.
Schwannoma of the orbit may be a part of the systemic involvement of Recklingnausen's neurofibromatosis. In such cases the tumour may show sarccmatous degeneration.
The site of nerve involvement within the orbit is by and large difficult to make out. However, the topographical locations of the tumour reported according to different authors are as follows: superior, inferior, lateral, central or filling the entire orbit had,,,,.
What is Schwannoma ? The protracted debate in regard to the lack of unanimity in the classical experimental work of Masson in which he had very clearly demonstrated the cytogenetic origin of the tumour. It was "sheath of Schwann", a neuroectodermal structure and not endoneurium which is a mesenchymal supporting tissue. In this context use of neurofibroma and Schwannoma as two separate entities, as has been done by some authors becomes confusing.
| Summary|| |
A not too common tumour of the orbit namely Schwannoma has been reported. The cytogenetic origin of the tumour has also been discussed.
| References|| |
Cohen. 1925, Quoted from Duke-Elder's Text book of Ophthal , 5, 5581, 1952. Henry Kimpton, London.
Duke-Elder, S.S., 1952, Text book of Ophthal., 5, 5580, Henry Kimpton, London.
Focosi, 1935. Quoted from Duke-Elder's Text Book of Ophthal., 5, 5581, Henry Kimpton London.
Friedenwald, 1929, Path of the Eye., N,Y.
Masson, P. 1932, Amer. J., Path. 8,
Mohan, S. & Sen, D.K., 1973. Indian Jour. Ophthal. 21; 4,
Motto 1937, Quoted from Duke-Elder's text book of Ophth., 5, 5571, 1952. Henry Kimpton, London.
Pescatori, 1929, Quoted from Duck-Elder's text book of Ophth, 5, 5581, 1952, Henry Kimpton, London.
Sitchevska, 1935, Quoted from Duke-Elder's text book of Ophthal., 6, 5581, 1952. Henry Kimpton, London.
Standel, B. 1950. Acta. Ophthal., 28.
Zimmermann, L.E., 1971, Pathology by W.A.D. Anderson, Vol. 2, p. 1016, 1971. The C. V. Mosby Company
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]