Abducens nerve schwannoma of the cavernous sinus: A case report and literature review

Abstract

Background: Schwannomas of the abducens nerve are a rare pathology and are encountered less within the cavernous sinus. We describe a case of sixth cranial nerve schwannoma, in the cavernous sinus.

Case description: A 50-year-old lady, presented with 2 years history of double vision and left facial numbness that started 6 months before presentation, found to have hyperintense lobulated mass at the left cavernous sinus extending into Meckel's cave with bony remodeling on magnetic resonance imaging. She underwent left frontotemporal craniotomy, combined extra-intradural approach, gross total resection. She had a gradual recovery of the sixth cranial nerve function.

Conclusion: Abducens nerve schwannoma of the cavernous sinus is a rare and challenging tumor. However amenable to surgical intervention with favorable neurological outcome.

Keywords: Abducens nerve; Cavernous sinus; Classification; Neurilemoma; Neurinoma; Neuroma; Schwannoma.

Figure 1:

(a-d) Preoperative magnetic resonance imaging. Magnetic resonance imaging: Heterogeneous T2 hyperintense lobulated mass at the left cavernous sinus extending into Meckel’s cave with bony remodeling, also with extension into left prepontine cistern, with avid contrast enhancement with no imaging evidence of intratumoral cystic degeneration or dural tail.