Authors
Tsyganova T.A., Skorokhvatova E.V., Denisenko A.N.
Сity Clinical Hospital No. 35, Nizhny Novgorod
Abstract
Rationale: Uveal tract schwannomas are extremely rare tumors that can mimic choroidal melanoma, which makes diagnosis and treatment tactics difficult. Despite the fact that this is a benign tumor, if untimely treatment is not provided, it can reach the degree of melanoma differentiation and have extraocular growth, which changes the vital prognosis.
Objective: To present a clinical case of choroidal schwannoma, analyze the features of diagnosis and choice of treatment tactics.
Methods: Diagnostics and examinations were performed at the State Budgetary Healthcare Institution of the Nizhny Novgorod Region “City Hospital No. 35 of the Sovetsky District” of Nizhny Novgorod and included: examination of the fundus under conditions of drug-induced mydriasis, B-scanning, histological and IHC studies of the enucleated eyeball.
Results: According to the results of the morphological study, a rare tumor of the uveal tract, namely schwannoma, was obtained, which was subsequently confirmed by the performed IHC study.
Conclusion: Despite the benign nature of the tumor, its tendency to imitate uveal melanoma and the peculiarities of the clinical course (a high percentage of relapses after non-radical surgical treatment, frequent extraocular growth, pain syndrome developing due to the size and inevitable loss of visual functions), enucleation is a relevant method of surgical treatment as a treatment tactic, since all organ-preserving interventions lead to continued tumor growth.
Keywords: intraocular schwannoma, melanoma, choroidal tumor, enucleation.
References
1. Grishina ЕЕ, Nechesniuk SIu. Uveal schwannoma mimicking melanoma (case report). Russian Annals of Ophthalmology. 2014;130(2):50‑53. (In Russ.)
2. Saakian SV, Amirian AG, Tsygankov AIu, Zhil’tsova MG, Zakharova GP, Andreeva LD. Intraocular schwannoma case report: clinical and pathomorphological analysis. Russian Annals of Ophthalmology. 2014;130(2):54 58. (In Russ.)
3. Baranova I.B., Slavnova E.N., Petrov A.N. Cytological diagnosis of schwannoma: 3 case reports. Russian News of Clinical Cytology. 2023;27(2):25-29.(In Russ.)
4. Reyes AG, Lewis CY, Pham C, Boldt HC, Lozano LP, Syed NA, Binkley EM. Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient. Am J Ophthalmol Case Rep. 2024 Jul 31;36:102137.
5. Dong, L., Xu, XL., Li, HY. Et al. Intraocular schwannoma: case seriesof 28 patients and literature review. Eye 38, 1314–1319 (2024).
6. Yu Y, Cheng Y, Wang K, Sun K, Shen D, Liang J. Intraocular schwannoma: A case series of 3 patients. Oncol Lett. 2019 Jan;17(1):1274-1278.
7. You JY, Finger PT, Iacob C, McCormick SA, Milman T. Intraocular schwannoma. Surv Ophthalmol. 2013 Jan-Feb;58(1):77-85.
8. Zhang T, Feng LJ, Wang Y, Shi YH, Wang L, Sun YM, Wei YT, Zhang SC. Multimode imaging characteristics and treatment of uveal schwannoma. Int J Ophthalmol 2022;15(3):446-452
9. Kir’yanova A. N. Sluchai lozhnopolozhitel’noi diagnostiki melanomy khorioidei // Zdorov’e, demografiya, ekologiya finno-ugorskikh narodov. – 2022. – № 3. – S. 44-46. (In Russ.)
10. Osteoma khorioidei (sluchai iz praktiki) / A. S. Borisenko, V. A. Vitt, T. K. Volkovich, L. V. Naumenko // Oftal’mologiya. Vostochnaya Evropa. – 2014. – № 4(23). – S. 121-125. (In Russ.)
11. Polyakov V.G., Ushakova T.L., Kurshin A.A., Gorovtsova O.V., Bekyashev A.H., Gasparyan T.G, Artemenko Y.V., Glekov I.V.. Malignant medulloepithelioma of the optic nerve with intraocular proliferation, imitating retinoblastoma: a clinical case and literature review. Pediatria n.a. G.N. Speransky. 2019; 98 (4): 109-115. (In Russ.)
