Orbital neurilemmoma with café-au-lait pigmentation of the skin.

Examination.-The left eye was normal with visual acuity 6/12. The right eye showed proptosis 20 mm. (left 15 mm.), and deviated outwards with limitation of ocular movements inwards. The fundus showed optic atrophy and the visual acuity was hand movements. A firm mass was felt in the inner side of the orbit extending backwards. Surgery.-Through a medial fomix conjunctival incision the tumour was removed by blunt finger dissection. It was encapsulated and firm, measuring 3 x 3 cm., with a smooth surface (Fig. 3, opposite) and pink in colour. Histopathological Examination.-There were spindle Schwann cells with elongated nuclei showing the characteristic palisade arrangement. Between the cells were long slender straight or serpentine reticulum fibres giving the appearance of spindle cellular fibrillar tissue of Antoni type A (Fig. 4, opposite). There were no nerve fibrils. The appearances were those of a neurilemmoma.