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Published on: July 5, 2021
Primary recurrent orbital schwannoma treated with surgical excision and Mitomycin-C
Kai Ching Peter Leung1, Nerissa Kei Yen Lam2, Edwin Chan1
1Department of Ophthalmology, Tung Wah Eastern Hosptial, Causewaybay, Hong Kong.
Purpose:
Primary orbital schwannoma (POS) is a slow growing, benign encapsulated peripheral nerve sheath tumor that occurs infrequently within the orbit. Recurrence of POS is extremely rare. Previous speculations for reasons of recurrence include incomplete excision and tumor seeding.
Observations:
We present the fifth case reported in the literature to date of POS that had 2 episodes of recurrences within 8 years after diagnosis, in which rapid and insidious relapses were observed after initial surgical resection. This is also the first reported recurrent POS in which topical Mitomycin-C (MMC) has been employed during surgical excision with an aim to prevent further recurrences.
Conclusions:
AND IMPORTANCE: Whilst complete surgical excision remained the standard for management for most POS, when there are multiple recurrences and in cases where total excision is not possible, addition of topical MMC may be an option that may bring about tumour regression as demonstrated in our case.
Insights
Primary orbital schwannoma (POS) is a rare tumor. Topical Mitomycin-C (MMC) may help prevent recurrence after surgery when complete excision is challenging.
Area of Science:
- Ophthalmology
- Neurosurgery
- Oncology
Background:
- Primary orbital schwannoma (POS) is a rare, slow-growing, benign peripheral nerve sheath tumor.
- Recurrence of POS is exceptionally uncommon, with incomplete excision or tumor seeding as suspected causes.
Observation:
- This report details the fifth documented case of recurrent POS, experiencing two relapses within eight years post-diagnosis.
- The case involved rapid and insidious tumor regrowth following initial surgical resection.
Findings:
- Topical Mitomycin-C (MMC) was utilized during surgical excision in this recurrent POS case, representing a novel therapeutic approach.
- The study explores the potential of topical MMC in managing recurrent orbital schwannomas.
Implications:
- While complete surgical excision is the standard for POS, topical MMC may offer a viable adjunct treatment for recurrent or incompletely excised tumors.
- This approach could potentially induce tumor regression in challenging POS cases, as suggested by the presented findings.
