Oculomotor Nerve Schwannoma: A Case Report and Review of the Literature
Kriangsak Saetia MD*, Noppadol Larbcharoensub MD**, Narongdet Wetchagama MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Oculomotor nerve schwannomas are extremely rare tumors. There are only 40 cases reported in the literature.
There is no standard treatment for these rare tumors.
Case Report : The authors have reported a case of a 41-year-old Thai man presenting with progressive visual loss of the left
eye for 6 months without diplopia. Visual acuity was 20/70 in the right and 20/400 in the left. There was no limitation of eye
movement. MRI showed a 42.5 ml mass in the suprasellar region compatible with a schwannoma. The patient underwent a
left pterional craniotomy with partial tumor removal. The pathological section confirmed a diagnosis of schwannoma and the
patient received postoperative stereotactic radiotherapy.
Conclusion : Options for treating these rare tumors include clinical observation, surgical resection or stereotactic radiation.
High incidence of complete third nerve palsy following surgery has been reported in the literature. Therefore, a subtotal
removal of large oculomotor schwannoma followed by stereotactic radiotherapy could provide a safer alternative compared
to radical surgery.
Keywords : Oculomotor nerve, Schwannoma
