# Case Report: Bilateral perineuroma of the orbit presenting as vertical binocular diplopia

## TL;DR

A 65-year-old woman was diagnosed with a rare bilateral orbital tumor causing double vision.

## Contribution

This is the first reported case of bilateral perineuroma in the orbit, a rare tumor location.

## Key findings

- The patient presented with vertical binocular diplopia, proptosis, and ophthalmoplegia.
- CT imaging revealed bilateral enhancing orbital masses confirmed as perineuroma via biopsy.
- The tumor was positive for EMA and CD34 markers.

## Abstract

In this case report, we describe a 65-year-old woman who presented to the ophthalmology clinic with vertical binocular diplopia for approximately 2 years. Visual exam was notable for bilateral proptosis and ophthalmoplegia. A computed tomography (CT) of the head revealed bilateral enhancing orbital masses. A biopsy was performed, and the result was positive for epithelial membrane antigen (EMA) and CD34, confirming a diagnosis of perineuroma. To our knowledge, this is the first reported case of bilateral perineuroma of the orbit, a rare location for an already uncommon benign tumor.