Proptosis From Neurofibroma (Kennerdell Case 66)
John S. Kennerdell, MD
Chair, Department of Ophthalmology Allegheny General Hospital Professor, Ophthalmology
Drexel University College of Medicine
Case 66 - Slide 1/14
A 38-year-old man who was referred with chronic proptosis of the right eye with minimal visual disturbance. The proptosis measurements were 22 right and 18 left with a base of 106. There was no pain associated with the proptosis.
Case 66 - Slide 2/14
A café au lait spot on the patient’s skin indicating a patient with neurofibromatosis.
Case 66 - Slide 3/14
An axial CT scan of the irregular lesion in the superior right orbit with a variable internal consistency.
Case 66 - Slide 4/14
The lower axial view of the lesion in the region of the right optic nerve.
Case 66 - Slide 5/14
An unenhanced axial view of an MRI scan showing the lesion in the superior portion of the right orbit.
Case 66 - Slide 6/14
An unenhanced coronal MRI showing the lesion in the superior right orbit as a rounded lesion in the region of the superior rectus muscle.
Case 66 - Slide 7/14
The bony burr holes in the calvarium in the right frontal cranial orbitotomy being performed by a neurosurgeon.
Case 66 - Slide 8/14
The removal of the calvarium to gain access to the lesion in the superior right orbit.
Case 66 - Slide 9/14
The microscopic view of the reddish lesion in the superior right orbit.
Case 66 - Slide 10/14
A cryoprobe extracting the rounded irregular lesion from the superior right orbit.
Case 66 - Slide 11/14
The gross specimen of the solitary neurofibroma removed from the superior portion of the right orbit through the craniotomy.
Case 66 - Slide 12/14
The bony craniotomy site being replaced
Case 66 - Slide 13/14
The patient one month post-operatively with elimination of the right proptosis. He had no functional deficit.
Case 66 - Slide 14/14
An overhead view of the patient’s eyes showing the symmetry of the forward placement of both eyes.