Left proptosis and reduced vision
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There is gross left-sided proptosis with a large multiloculated cystic mass centered in the left cavernous sinus extending through the superior orbital fissure into the left intraconal space. It is predominantly fluid signal, with some hemorrhagic fluid-fluid levels. There is peripheral contrast enhancement. Mass effect on the cavernous segment of left ICA and left temporal lobe. The optic nerve is stretched around the medial aspect of the lesion.
The patient underwent surgery and the well-circumscribed mass was successfully removed. The optic, oculomotor, trochlear and abducens nerves were normal. Histopathology confirmed a benign schwannoma. In our case, the tumor was a trigeminal schwannoma affecting the first division of the trigeminal nerve (ophthalmic division).