Atypical, Extremely Rapid Growth of Pediatric Orbital Neurilemmoma

Solitary orbital neurilemmoma-a benign tumor of Schwann cells in a peripheral nerve-sheath-are typically very slow growing and present in middle age; in the absence of neurofibromatosis, they are almost never seen in childhood. We describe the clinical presentation, imaging, pathology, and management of this tumor in a 12 years old-the tumor growing extremely rapidly over 5 months and without any evidence of cystic degeneration, hemorrhage, or sarcomatous features. The possibility of tumor growth having been accelerated by prior biopsy is discussed.