Objective and importance: Oculomotor schwannoma is extremely rare. We report a case of oculomotor schwannoma with consideration of its surgical management.
Clinical presentation: A 64-year-old woman with a history of chronic headache underwent a computed tomographic scan, which revealed a mass lesion in the right prepontine cistern. She had no neurological deficits at admission.
Intervention: The tumor originated from the right oculomotor nerve. It was subtotally removed, leaving a tiny part attached to the nerve. The nerve trunk was preserved. A pathological examination revealed a schwannoma. Transient right oculomotor nerve palsy occurred postoperatively, but it improved almost completely.
Conclusion: The tumor in the present case was resected, preserving serviceable oculomotor function. However, among 16 patients reported in the literature, all but one developed or maintained severe postsurgical oculomotor nerve palsy. We conclude that surgical resection generally is not indicated for oculomotor schwannomas, excluding large tumors that cause intractable symptoms.