Abducens nerve schwannoma: A case report and review of literature

Background: Abducens nerve schwannomas are rare skull base tumors, frequently affect the cavernous sinus and develop near the brainstem. There is limited literature on their optimal management. Surgery and/or stereotactic radiosurgery are available as therapeutic options. Significant morbidity, including nerve function loss, can result from resection. Stereotactic radiosurgery is an option for treating other schwannomas.

Case Description: We report a case of a 30-year-old woman with no known medical history presented with a 4-year history of recurrent double vision with limited abduction on lateral gaze secondary to paresis of the right abducens nerve. A heterogeneous mass at the right cavernous sinus was found from neuro-imaging (MRI).

Considering the clinical status of patient and imaging findings, we decided to proceed with stereotactic radiosurgery. After She presented an improvement with absence of the diplopia and complete neurological recovery. The control MRI was carried out after 6 months, showing a clear reduction in tumor volume of at least 50%.

Conclusion: Gamma Knife Radio Surgery (GKRS) looks to be a safe and effective minimally invasive treatment option for such lesions, with excellent rates of tumor control and symptomatic improvement possible. Consequently, it is reasonable to consider GKRS as a first-line treatment option for oculomotor nerve schwannomas.