Purpose: To analyze the imaging findings in patients diagnosed with isolated orbital neurofibromas. Design: Retrospective observational case series. Methods: Computed tomographic (CT) and magnetic resonance imaging (MRI) findings were reviewed in five patients with orbital neurofibromas in the absence of systemic neurofibromatosis in this multicenter study. The main outcome measures were bony and soft tissue abnormalities involving the orbit and surrounding anatomic spaces. Results: Patient age ranged from 36 to 43 years (mean, 41 years); three patients were men and two were women. Duration of symptoms ranged from three to 20 years. Radiologic findings included intraconal and extraconal soft tissue masses in all patients, bony orbital abnormalities in three patients, and intracranial extension in two patients. In addition, MRI studies in one patient revealed the previously unreported presence of neurofibromas involving extraocular muscle. Conclusions: Isolated orbital neurofibromas may present with differing radiologic appearances. The combined use of high-resolution CT and MRI may be of benefit in the preoperative diagnosis of these uncommon orbital tumors.
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