Orbito-cranial schwannoma - a multicenter experience

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dc.contributor.authorShapira, Y.
dc.contributor.authorJuniat, V.
dc.contributor.authorDave, T.
dc.contributor.authorHussain, A.
dc.contributor.authorMcNeely, D.
dc.contributor.authorWatanabe, A.
dc.contributor.authorYoneda, A.
dc.contributor.authorSaeed, P.
dc.contributor.authorWoo, K.I.
dc.contributor.authorHardy, T.
dc.contributor.authorSelva, D.
dc.date.issued2023
dc.descriptionPublished online: 09 January 2022
dc.description.abstractOBJECTIVES: To describe the features, management approaches, and outcomes of orbito-cranial schwannomas. METHODS: Retrospective review of ten patients with orbito-cranial schwannomas managed in six orbital services over 22 years. Data collected included demographics, presenting features, neuroimaging characteristics, histology, management approach, complications, and outcomes. RESULTS: Mean age of the patients was 41.4 ± 19.9 years, and 6 (60%) were females. The majority presented with proptosis (90%), limited extraocular motility (80%), eyelid swelling (60%), and optic neuropathy (60%). Most lesions (80%) involved the entire anterior-posterior span of the orbit, with both intra- and extraconal involvement. All tumours involved the orbital apex, the superior orbital fissure, and extended at least to the cavernous sinus. Surgical resection was performed for all. Seven (70%) of the tumours were completely or subtotally resected combining an intracapsular approach by an orbital-neurosurgical collaboration, with no recurrence on postoperative follow-up (6–186 months). Three underwent tumour debulking. Of these, two remained stable on follow-up (6–34 months) and one showed progression of the residual tumour over 9 years (cellular schwannoma on histology) necessitating stereotactic radiotherapy (SRT) for local control. Adjuncts to the orbito-cranial resection included perioperative frozen section (n = 5), endoscopic transorbital approach (n = 2), and image-guided navigation (n = 1). Post-surgical adjuvant SRT was used in three subjects. CONCLUSIONS: These results highlight the possibility of successful surgical control in complex orbito-cranial schwannomas. A combined neurosurgical/orbital approach with consideration of an intracapsular resection is recommended. Recurrence may not occur with subtotal excision and observation may be reasonable. Adjunctive SRT for progression or residual tumour can be considered.
dc.description.statementofresponsibilityYinon Shapira, Valerie Juniat, Tarjani Dave, Ahsen Hussain, Daniel McNeely, Akihide Watanabe, Akiko Yoneda, Peerooz Saeed, Kyung In Woo, Thomas G. Hardy, Benjamin Price, Kate Drummond and Dinesh Selva
dc.identifier.citationEye, 2023; 37(1):48-53
dc.identifier.doi10.1038/s41433-021-01850-1
dc.identifier.issn0950-222X
dc.identifier.issn1476-5454
dc.identifier.orcidSelva, D. [0000-0002-2169-5417]
dc.identifier.urihttps://hdl.handle.net/2440/134231
dc.language.isoen
dc.publisherSpringer
dc.rights© The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2021
dc.source.urihttps://doi.org/10.1038/s41433-021-01850-1
dc.subjectOrbit
dc.subjectHumans
dc.subjectNeurilemmoma
dc.subjectNeoplasm, Residual
dc.subjectOptic Nerve Diseases
dc.subjectEndoscopy
dc.subjectTreatment Outcome
dc.subjectRetrospective Studies
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.titleOrbito-cranial schwannoma - a multicenter experience
dc.typeJournal article
pubs.publication-statusPublished

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