|Year : 1980 | Volume
| Issue : 2 | Page : 95-96
Neurilemoma of optic nerve
RG Kulkarni, VY Satalkar, AW Bhawthankar
S. R.T.R. Medical College, Ambajogai and Medical College, Aurangabad, India
R G Kulkarni
Medical College, Aurangabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kulkarni R G, Satalkar V Y, Bhawthankar A W. Neurilemoma of optic nerve. Indian J Ophthalmol 1980;28:95-6
Neurilemoma is a localised, encapsulated, benign nerve sheath tumour occurring anywhere along the course of the peripheral, cranial or sympathetic nerves. These tumours rarely recur after local excision even if the capsule is left behind.
Many cases of neurilemomas of the orbit have been reported. These tumours have no distinctive clinical picture. They progress slowly over a period of years and possibly intermittently.
Neurilemomas usually cause exophthalmos and blurring of vision with restriction of ocular movements. As the tumour was arising from optic nerve in this case, blurring of vision appeared first followed by ex-ophthalmus and finally restriction of movement.
| Case report|| |
A 15 years old male presented with the gradual diminution of vision and gradual prominence of left eye of one year duration and restriction of movements of left eye for 6 months. He had a mild blunt injury on left forehead. He postponed his visit to the hospital for fear of operation.
On examination left eye was proptosed, displaced up and in. There was well marked fullness in lower and outer quadrant of the orbit and congestion in lower half of the conjunctiva with lagophthalmos. There was no perception of light. E x-ophthalmometer reading was 37 mm on left side, while on right side it was 15 mm. All movements were restricted. Cornea was clear and sensations were present. The pupil was dilated and fixed. Consensual reaction was positive.
Fundus examination showed pallor of disc with blurred margin, narrowed arteries, retinal oedema and folds in the lower outer quadrant.
On palpation there was a tumour mass palpable in lower and outer quadrant, smooth and firm in consistency, mobile from side to side and was non reducible. Right eye was normal.
All investigations were normal. Lateral orbitotomy revealed a fusiform white shiny tumour mass extending from the optic canal to the posterior pole of the eye ball and coming forward. Optic nerve could not be identified separately. The mass was cut near the eye ball and near the optic canal and taken out. It appeared to be an enlarged optic nerve. The wound was closed after keeping a corrugated rubber drainage.
In the fundus of the same eye cherry red spot appeared on 4th day. The arteries gradually disappeared but the veins were dialated and full with a tortuous course. The retinal oedema disappeared on 15th day following treatment with prednisolone 20 mg daily for 12 days and the retina assumed pink-colour gradually. The peculiarity of the retinal colours was that at the posterior pole, from disc to macula, it was constantly pink. The sutures were removed on 10th. postoperative day. Corneal sensations were retained.
On gross examination the tumour mass was well encapsulated, fusiform smooth, grayish white and firm in consistency having a size of 5 c.m. in length and 3 cm. in circumference, broader near the optic canal and narrower towards the eyeball [Figure - 1].
On microscopic examination, the tissue showed solid areas showing a cellular pattern. The cells were spindle shaped with long narrow nuclei. In some areas there was a fascicular pattern while other areas showed a palisading arrangement [Figure - 2].
| Discussion|| |
A case of neurilemoma arising from optic nerve in a male patient aged 15 years, having loss of vision as a first symptom, then proptosis and restriction of the eye movements, is presented. Only tumour mass was removed. The eye ball was retained so that post operatively patient will have a better cosmetic appearance.
| Summary|| |
A case of Neurilemoma of optic nerve is presented with its management.
| References|| |
Cohen, M, 1925, Arch. Ophthalmol, 54:426.
Reese A.B., 1963, `Tumours of the eye' Ed. 2nd P. 190-202 534-35, Paul B. Horber Inc. N.Y.
Nath, K. and Gogi, R., 1976. Ind. J. Ophthalmol., 24,1 : 1.
[Figure - 1], [Figure - 2]