A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia.

Kee, Hyun Ju; Yoo, Yung Ju; Kim, Jae Hyoung; Yang, Hee Kyung

doi:2016.57.11.1812

J Korean Ophthalmol Soc > Volume 57(11); 2016 > Article

Case Report

Journal of the Korean Ophthalmological Society 2016;57(11):1812-1816.
DOI: https://doi.org/10.3341/jkos.2016.57.11.1812 Published online November 15, 2016.

A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia.

Hyun Ju Kee, Yung Ju Yoo, Jae Hyoung Kim, Hee Kyung Yang

¹Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. nan282@snu.ac.kr
²Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

양안 복시로 나타난 도르래신경초종 1예

기현주¹⋅류영주¹⋅김재형²⋅양희경¹

서울대학교 의과대학 분당서울대학교병원 안과학교실¹, 서울대학교 의과대학 분당서울대학교병원 영상의학교실²

Abstract

PURPOSE
To report a case of unilateral trochlear nerve schwannoma in a patient without neurofibromatosis. CASE SUMMARY: A 58-year-old male presented with acute onset of diplopia which developed 10 days prior. Alternate prism cover test, ductions and versions and Bielschowsky three-step test were compatible with left superior oblique muscle palsy. High-resolution magnetic resonance imaging showed a 6-mm-sized lobulated mass in the cisternal segment of the left trochlear nerve passing lateral to the brainstem. An additional thin-section gadolinium-enhanced orbit magnetic resonance imaging showed definite enhancement in the entire portion of the lobulated mass, compatible with a trochlear nerve schwannoma. Diplopia was managed conservatively with prism glasses and regular follow-up examinations were recommended without further treatment. CONCLUSIONS: A trochlear nerve tumor should be considered in adults who develop diplopia associated with acquired superior oblique muscle palsy.

Key Words: Acquired superior oblique muscle palsy;Trochlear nerve schwannoma;Trochlear nerve tumor