Rare case of orbital schwannoma with intralesional haemorrhage and fluid-fluid levels

Description

We report a case of a 23-year-old man who presented with a 1-month history of gradually worsening right eye pressure, blurry vision and proptosis, which was not exacerbated with Valsalva or change in position.

MRI of the orbits demonstrated a well-defined, lobulated, cystic, trans-spatial mass with areas of internal haemorrhage (figure 1) and fluid–fluid levels (figure 2) in the superior medial right orbit, which extended posteriorly through the superior orbital fissure to the cavernous sinus (figure 3). The lesion slightly expanded the orbital fissure, mildly deformed the posterior globe and demonstrated peripheral and septal enhancement (figure 4).

Figure 1

Axial T1: increased T1 signal within the lesion located in the right periorbital space indicating haemorrhage.

Figure 2

Axial T2 (superior): multiple fluid–fluid levels.

Figure 3

Axial T2...

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