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Disease&Treatment/Oculoplastics
Schwannoma Neurilemmoma Orbital and Conjunctival Eyelid Occurrence, Clinical Features, Imaging Findings, Surgical Treatment, Histological Diagnostic Criteria
eye_doc 2025. 4. 21. 23:49
👁 “Orbital Schwannoma – From Anatomy to Histologic Diagnosis”
Schwannoma, also called neurilemmoma, is a benign tumor originating from Schwann cells
of the peripheral nerve sheath.
It is usually solitary in healthy individuals, but multiple lesions may indicate Neurofibromatosis Type I.
In ophthalmology, schwannomas are rare but may occur in the orbit, conjunctiva, uvea, or even eyelid.
🧠 Summary Table for Orbital Schwannoma
CategoryDetails
| Origin | Schwann cell (neural sheath) |
| Common Locations | Spine, cranial nerves, orbit |
| Ocular Sites | Orbit > conjunctiva > ciliary body > choroid > eyelid |
| Imaging Findings | |
| – Well-defined, homogenous mass on MRI | |
| – Enhancement with contrast | |
| – May be intra- or extraconal | |
| Symptoms | |
| – Proptosis, displacement of globe | |
| – Optic nerve compression → visual symptoms | |
| Surgical Indications | |
| – Rapid growth, compressive symptoms | |
| – Suspicion of malignancy | |
| Histologic Diagnosis | |
| – Antoni A: Densely packed spindle cells | |
| – Antoni B: Loosely arranged cells | |
| – Strong S-100 positivity on immunostaining |
✅ Clinical Insight
– When suspected orbital mass shows homogenous features and is well-encapsulated: consider schwannoma
– Biopsy required for definitive diagnosis; S-100 marker is key
– If malignant features are noted → consider orbital exenteration