Korean J Ophthalmol.  2009 Mar;23(1):49-52. 10.3341/kjo.2009.23.1.49.

A Choroidal Schwannoma Confirmed by Surgical Excision

• Cho YJ
• Won JB
• Byeon SH
• Yang WI
• Koh HJ
• Kwon OW
• Lee SC

• KMID: 1115653
• DOI: http://doi.org/10.3341/kjo.2009.23.1.49

Abstract

Schwannomas rarely present as intraocular tumors and are often misdiagnosed as malignant melanoma. We describe a choroidal schwannoma confirmed by sclerouvectomy. A 30-year-old woman presented with a large nonpigmented intraocular mass of the choroid in the right eye and underwent surgical excision by sclerouvectomy. Histologically, the tumor was composed of a mixture of cellular solid components (Antoni A) and loose myxoid components (Antoni B). The tumor was eventually diagnosed as a schwannoma. Currently available ancillary studies are still of little value in definitively differentiating schwannomas from other choroidal tumors. In the case of atypical findings for a malignant melanoma, a benign neoplasm should be included in the differential diagnosis. This patient avoided enucleation by first having the mass excised. We are unaware of previous reports in which a choroidal schwannoma was diagnosed by surgical excision.

Keyword

Schwannoma; Sclerouvectomy; Enucleation

MeSH Terms

Adult
Choroid/*pathology
Choroid Neoplasms/*diagnosis/surgery
Diagnosis, Differential
Eye Enucleation/*methods
Female
Humans
Magnetic Resonance Imaging
Neurilemmoma/*diagnosis/surgery

Figure

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  Fig. 1 (A) Fundus photography of the superonasal quadrant of the right eye. Note the presence of a nonpigmented choroidal mass with serous fluid. (B) Ultrasonogram showing a choroidal mass containing a cystic component and demonstrating medium reflectivity. (C) MRI (magnetic resonance imaging) showing low signal intensity in T2-weighted images. (D) Signal intensity in T1-weighted images showing marked enhancement. (E) Gross specimen approximately 3×1×1 cm in size with a cystic component. (F) Postoperative fundus photography.

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  Fig. 2 (A) A well circumscribed mass with multifocal cystic changes (H-E, ×12). (B) The mass shows alternating hypercellular (Antoni A: stars) and hypocellular (Antoni B: arrows) areas (H-E ×40). (C) The periphery of the mass shows melanin-containing cells. The mass seems to arise from the choroid membrane (H-E ×200). (D) The hypercellular area shows bland spindle cells with whorling patterns (×200). These histologic features are consistent with a schwannoma.

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