• Kazuma Doi, Naoki Otani, Daichi Hagita, Midori Horiuchi, Satoru Takeuchi, Terushige Toyooka, Kojiro Wada, Motohiro Hayashi, and Kentaro Mori.
• Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan. Electronic address: mogulaiko1987@yahoo.co.jp.
• World Neurosurg. 2020 Nov 1; 143: 197-201.

BackgroundSchwannoma originating from the oculomotor nerve has been reported. However, meningioma originating from this nerve was unknown.Case DescriptionA 22-year-old woman presented with a unique case of meningioma originating from the oculomotor nerve manifesting as periorbital pain and diplopia beginning 4 months previously. Oculomotor nerve schwannoma was suggested by several pretreatment examinations. Tumor resection was considered risky for preservation of the oculomotor nerve function; therefore, gamma knife surgery (GKS) was performed. Six months later, she suffered right complete ptosis and worsened blurry vision. Corticosteroid was administered, but her symptoms did not improve. Magnetic resonance imaging showed the tumor lesion had grown larger. We decided to resect the tumor lesion because of her uncontrolled periorbital pain. The tumor had occupied the oculomotor cistern and was gross totally removed. Histologic diagnosis was surprisingly transitional meningioma. The tumor lesion occupied the oculomotor cistern and was refractory to GKS, with a progressive clinical course, which is more suggestive of meningioma than schwannoma, although extremely rare. Her periorbital pain and blurry vision gradually regressed, whereas complete oculomotor nerve palsy persisted.ConclusionsIn such a case, tumor resection after GKS should be considered.Copyright © 2020 Elsevier Inc. All rights reserved.

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