{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:15:09Z","timestamp":1788243309758,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Primary oculomotor nerve schwannomas that involving the cavernous sinus represent an exceptionally rare entity. The surgical management of these tumors is complicated by the need to maximize resection while safeguarding oculomotor function. We report a middle-aged female who presented with headache, dizziness, and visual decline. Examination showed right ptosis and decreased visual acuity. MRI demonstrated a lesion in the right parasellar region that involved the cavernous sinus, circumferentially surrounded the cavernous segment of the internal carotid artery, and extended into the optic canal. A right pterional craniotomy was performed with a microsurgical resection under endoscope assistance. Following microsurgical debulking through the oculomotor trigone and supratrochlear triangle, neuroendoscopy was used to explore and curette deep residual tumor within the cavernous sinus. Histopathology confirmed schwannoma of Schwann cell origin. Postoperatively, ptosis showed partial improvement and visual acuity showed mild improvement, with oculomotor and pupillary function preserved without postoperative deterioration. Postoperative MRI obtained within 72 hours confirmed an intentional subtotal resection with a minimal residual enhancing focus, for which adjuvant stereotactic radiosurgery has been recommended. In this patient, endoscopic visualization facilitated inspection of areas not directly visible through the microscope and supported an intentional function-preserving resection. The surgical strategy illustrated in this case may inform the management of this rare pathology, although long-term outcomes remain to be evaluated.<\/jats:p>","DOI":"10.3389\/fonc.2026.1854683","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:35:55Z","timestamp":1788240955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscope-assisted microsurgical resection of a primary oculomotor nerve schwannoma involving the cavernous sinus via a pterional approach: a case report with narrative review"],"prefix":"10.3389","volume":"16","author":[{"given":"Chong","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weifang People\u2019s Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weifang People\u2019s Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weifang People\u2019s Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weifang People\u2019s Hospital, Shandong Second Medical University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.oa.2020-0438","article-title":"Epidemiologic study of primary brain tumors in Miyazaki Prefecture: A regional 10-year survey in southern Japan","volume":"61","author":"Matsumoto","year":"2021","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pjnns.2016.01.001","article-title":"Surgery for sporadic vestibular schwannoma. Part I: General outcome and risk of tumor recurrence","volume":"50","author":"Kunert","year":"2016","journal-title":"Neurol Neurochir Pol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2021.11.008","article-title":"Oculomotor nerve schwannoma: case series and literature review","volume":"67","author":"Douglas","year":"2022","journal-title":"Surv Ophthalmol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-021-05283-9","article-title":"Malignant nerve sheath tumor of oculomotor nerve in a pediatric patient","volume":"38","author":"Alt\u0131nba\u015f","year":"2022","journal-title":"Childs Nerv Syst"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-230272","article-title":"Oculomotor schwannoma causing a progressive complete third-nerve palsy","volume":"12","author":"Bentley","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/wno.0000000000000994","article-title":"Recurrent third nerve palsy secondary to instrinsic schwannoma of the third cranial nerve","volume":"41","author":"Margolin","year":"2021","journal-title":"J Neuroophthalmol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1148\/rg.2019180122","article-title":"Imaging spectrum of cavernous sinus lesions with histopathologic correlation","volume":"39","author":"Mahalingam","year":"2019","journal-title":"Radiographics"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.702574","article-title":"Blood supply of cranial nerves passing through the cavernous sinus: An anatomical study and its implications for microsurgical and endoscopic cavernous sinus surgery","volume":"11","author":"Najera","year":"2021","journal-title":"Front Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-984306","article-title":"Microscopic and endoscopic extracranial approaches to the cavernous sinus: anatomic study","volume":"64","author":"Doglietto","year":"2009","journal-title":"Neurosurgery"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1080\/02841850600690413","article-title":"Malignant peripheral nerve sheath tumor of the oculomotor nerve","volume":"47","author":"Kozic","year":"2006","journal-title":"Acta Radiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-007-1150-0","article-title":"Sporadic Malignant nerve sheath tumour of the oculomotor nerve","volume":"149","author":"Santarius","year":"2007","journal-title":"Acta Neurochir (Wien)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414558886","article-title":"Oculomotor nerve tumors masquerading as recurrent painful ophthalmoplegic neuropathy: report of two cases and review of the literature","volume":"35","author":"Kim","year":"2015","journal-title":"Cephalalgia"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.5137\/1019-5149.jtn.13655-14.1","article-title":"Preoperative visualization of cranial nerves in skull base tumor surgery using diffusion tensor imaging technology","volume":"26","author":"Ma","year":"2016","journal-title":"Turk Neurosurg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.cr2012-0418","article-title":"Oculomotor nerve schwannoma associated with acute hydrocephalus: case report","volume":"54","author":"Iijima","year":"2014","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.03.191","article-title":"Oculomotor neurofibroma: A different histology implying an unsatisfying clinical outcome","volume":"139","author":"Matano","year":"2020","journal-title":"World Neurosurg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2013.05.021","article-title":"Conventional spindle cell-type Malignant peripheral nerve sheath tumor arising in a sporadic schwannoma","volume":"44","author":"Endo","year":"2013","journal-title":"Hum Pathol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1038\/modpathol.2014.109","article-title":"Morphologic and immunohistochemical features of Malignant peripheral nerve sheath tumors and cellular schwannomas","volume":"28","author":"Pekmezci","year":"2015","journal-title":"Mod Pathol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/neup.12004","article-title":"Malignant peripheral nerve sheath tumor of the trigeminal nerve: clinicopathologic features in a young adult patient","volume":"33","author":"Nakayama","year":"2013","journal-title":"Neuropathology"},{"key":"B19","doi-asserted-by":"publisher","first-page":"314","DOI":"10.25259\/sni_312_2020","article-title":"Meningothelial meningioma of the oculomotor nerve: A case report and review of the literature","volume":"11","author":"Sharifi","year":"2020","journal-title":"Surg Neurol Int"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000004330","article-title":"Postpartum recovery from meningioma-related oculomotor palsy","volume":"137","author":"Dawoud","year":"2021","journal-title":"Obstet Gynecol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2021.106689","article-title":"Clipping versus coiling in the treatment of oculomotor nerve palsy induced by unruptured posterior communicating artery aneurysms: A meta-analysis of cohort studies","volume":"206","author":"Zheng","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00440","article-title":"A case of recurrent painful ophthalmoplegic neuropathy","volume":"11","author":"Yan","year":"2020","journal-title":"Front Neurol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1556494","article-title":"Neurofibromatosis type 2 misdiagnosed as amblyopia-a case report and literature review","volume":"12","author":"Li","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opx174","article-title":"Parasellar schwannomas: Extradural vs extra-intradural surgical approach","volume":"14","author":"Mariniello","year":"2018","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.wneu.2019.05.170","article-title":"Prognosis factor in oculomotor schwannoma: A case of endoscopic endonasal approach and systematic review of the literature","volume":"129","author":"El Asri","year":"2019","journal-title":"World Neurosurg"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-017-3268-z","article-title":"Usefulness of intraoperative electromyographic monitoring of oculomotor and abducens nerves during skull base surgery","volume":"159","author":"Li","year":"2017","journal-title":"Acta Neurochir (Wien)"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-024-06322-x","article-title":"Successful surgical treatment of oculomotor palsy due to schwannoma of the cavernous sinus in a 7-year-old girl: a case report","volume":"40","author":"Ishino","year":"2024","journal-title":"Childs Nerv Syst"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-021-05048-y","article-title":"Management of non-vestibular schwannomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section. Part I: oculomotor and other rare non-vestibular schwannomas (I, II, III, IV, VI)","volume":"164","author":"Bal","year":"2022","journal-title":"Acta Neurochir (Wien)"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3171\/2020.8.jns20887","article-title":"Outcomes after stereotactic radiosurgery for schwannomas of the oculomotor, trochlear, and abducens nerves","volume":"135","author":"Langlois","year":"2021","journal-title":"J Neurosurg"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.05.114","article-title":"Oculomotor schwannomas: A systematic review and report of two pediatric cases treated with fractionated cyberknife stereotactic radiotherapy","volume":"129","author":"Fadel","year":"2019","journal-title":"World Neurosurg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1854683\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:35:56Z","timestamp":1788240956000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1854683\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":30,"alternative-id":["10.3389\/fonc.2026.1854683"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1854683","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"article-number":"1854683"}}