Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2022; 10(21): 7356-7364
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7356
Imaging characteristics of orbital peripheral nerve sheath tumors: Analysis of 34 cases
Min Dai, Ting Wang, Jun-Ming Wang, Li-Ping Fang, Ying Zhao, Asmitananda Thakur, Dong Wang
Min Dai, Department of Rehabilitation Center for Elderly, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
Ting Wang, Li-Ping Fang, Department of Respiratory Medicine, Xi'an People's Hospital (The Fourth Xi'an Hospital), Xi'an 710004, Shannxi Province, China
Jun-Ming Wang, Dong Wang, Department of Radiology, Xi'an People's Hospital (The Fourth Xi'an Hospital), Xi'an 710004, Shannxi Province, China
Ying Zhao, Department of Pathology, Xi'an People's Hospital (The Fourth Xi'an Hospital), Xi'an 710004, Shannxi Province, China
Asmitananda Thakur, Chest Clinic, NATA, Morang, Biratnagar 0097721, Nepal
Author contributions: All authors have read and approved the manuscript; Dai M drafted part of the manuscript, and is responsible for the revision and publication fees; Wang T performed the literature review and drafted part of the manuscript; Wang JM, Fang LP and Zhao Y collected the patient data; Thakur A critically polished the language; Wang D interpreted the data.
Supported by the Incubation Fund Project of the Xi’an People’s Hospital (The Fourth Xi'an Hospital), No. FZ-75.
Institutional review board statement: Our study was approved by the Institutional Committee for Research Involving Human Subjects of the Xi'an People's Hospital (The Fourth Xi'an Hospital). Informed consent forms listing relevant information needed to be collected were signed and obtained from the participants.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ting Wang, PhD, Doctor, Department of Respiratory Medicine, Xi'an People's Hospital (The Fourth Xi'an Hospital), No. 21 Jiefang Road, Xincheng District, Xi'an 710004, Shannxi Province, China. hdwt.ok@163.com
Received: March 1, 2022
Peer-review started: March 1, 2022
First decision: April 8, 2022
Revised: April 25, 2022
Accepted: June 14, 2022
Article in press: June 14, 2022
Published online: July 26, 2022
Processing time: 132 Days and 5.6 Hours
Abstract
BACKGROUND

Peripheral nerve sheath tumors (PNSTs), a rare group of neoplasms in the orbit, comprise only 4% of all orbital tumors. At present, there are very few studies detailing the features of these tumors identified using imaging technology.

AIM

To compare the differences in location, morphology, magnetic resonance imaging (MRI) signal intensity/computed tomography (CT) value, and enhancement degree of tumors of different pathological PNSTs types.

METHODS

Clinical, pathological, CT, and MRI data were analyzed retrospectively in 34 patients with periorbital sheath tumors diagnosed using histopathology from January 2013 to August 2021.

RESULTS

Among 34 cases of orbital peripheral nerve sheath tumors, 21 were schwannomas, 12 were neurofibromas, and 1 was a plexiform neurofibroma. Common clinical symptoms presented by patients with these types of tumors include eyelid swelling, exophthalmos, and limited eye movement. Schwannomas mostly occur in the intramuscular space with small tumor volume and rare bone involvement. Neurofibromas develop in the extrapyramidal space with larger tumor volume and more bone involvement. Radiologically, schwannomas and neurofibromas are characterized by regular morphology and uneven density and signal. One case of plexiform neurofibroma showed tortuous and diffuse growth along the nerve, with a worm-like appearance on imaging.

CONCLUSION

Different pathological types of orbital peripheral nerve sheath tumors have unique imaging characteristics. Comprehensive consideration of the patient's clinical and imaging manifestations is of great value in the diagnosis of orbital peripheral nerve sheath tumors.

Keywords: Periorbital nerve sheath tumor; Schwannoma; Neurofibroma; Plexiform neurofibroma; Imaging features

Core Tip: We analyzed clinical, pathological, computed tomography (CT), and magnetic resonance imaging (MRI) data retrospectively in 34 patients with periorbital sheath tumors diagnosed using histopathology during more than 7 years. The differences in location, morphology, MRI signal intensity/CT value, and enhancement degree of tumors of different pathological types were compared. Radiologically, schwannomas and neurofibromas are characterized by regular morphology and uneven density and signal. One case of plexiform neurofibroma showed tortuous and diffuse growth along the nerve, with a worm-like appearance on imaging.