Objective: To evaluate the diagnosis and surgery of orbital neurilemoma.
Methods: Thirty-eight patients with pathologically confirmed orbital neurilemomas were analyzed retrospectively. The age of the patients ranged from 9 years to 69 years. Twenty-three patients were female and fifteen were male. Standardized A/B scan was performed in 37 cases. CT scanning was performed in 38 patients with contrast scanning in 15 patients and MR imaging was performed in 33 patients with contrast scanning in 32 patients.
Results: Neurilemoma was generally low to medium reflective or echo in the ultrasound. Of the 38 cases with orbital neurilemomas, location of tumors was superior of the orbit in 17 cases; lateral and inferior in 19 cases and medial in 2 cases. Shape of the tumors was elongate or round-like 26 cases, leaf-like and dumb-bell 12 cases. CT scanning showed soft tissue high density mass in 32 cases, 6 cases were heterogeneity (for cystoid change). MR imaging in 33 patients displayed a identical T1 and a long T2 signal intensity weighted images in 4 cases; identical T1 and T2 mixed signal (short, identical and long signal) in 28 cases; identical T1 and T2 in 1 cases. After Gd-DTPA enhancement in 32 cases, heterogeneity enhancement of the mass was seen in 28 cases, marked enhancement 4 cases. Four cases in all cases was found orbital-cranial communicate mass. Surgical approach was lateral orbitotomy in 26 cases, combined lateral and medial orbitotomy in 2 cases, anterior orbitotomy 4 cases and medial orbitotomy in 2 cases.
Conclusions: Modern medical imaging, especial MR imaging can demonstrate the site, configuration, and characteristics of the tumors and contribute to the diagnosis and treatment. Skill of surgery can improve the rate of success and decrease the complications.