Oculomotor nerve schwannoma: a case report

Area of Science:

• Neuro-oncology
• Ophthalmology
• Neurosurgery

Background:

• Schwannomas represent 8% of intracranial tumors, with 90% being vestibular schwannomas.
• Oculomotor schwannoma, particularly without neurofibromatosis, is exceptionally rare.
• Intracranial tumors can present with diverse neurological deficits.

Purpose of the Study:

• To report an extremely rare case of oculomotor schwannoma.
• To describe the clinical presentation, surgical management, and outcome of this rare tumor.
• To highlight the diagnostic and therapeutic challenges of atypical schwannomas.

Main Methods:

• A case study of a 41-year-old female with blurred vision.
• Diagnostic imaging using Brain Magnetic Resonance Imaging (MRI).
• Surgical intervention via a fronto-temporal approach with subtotal tumor removal under microscopic guidance.

Main Results:

• Brain MRI revealed an extra-axial mass in the left superior orbital fissure, originating from the oculomotor nerve.
• Pathological examination confirmed the mass as a schwannoma.
• Post-surgery, the patient experienced temporary ptosis and medial gaze limitation, which showed gradual improvement.

Conclusions:

• Oculomotor schwannoma is a rare diagnosis that requires prompt surgical intervention.
• Microscopic subtotal removal is a viable surgical strategy for oculomotor schwannoma.
• Despite potential postoperative deficits, functional recovery is often observed in patients with oculomotor schwannoma.