Orbital apex schwannoma with a high titer of proteinase 3 antineutrophil cytoplasmic antibody()

Here, we present a very unusual case of orbital apex schwannoma with a high titer of proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA). A 67-year-old man presented with a 3-month history of double vision. Radiological examinations revealed a mass lesion at the left orbital apex, and laboratory examination revealed a high titer of PR3-ANCA, of 49.1 U/mL (reference range<2.0). After the surgery, the lesion was histologically diagnosed as schwannoma, and the PR3-ANCA titer decreased to 8.4 U/m. Although making a correct diagnosis of orbital apex schwannoma may be difficult due to the need to differentiate from granulomatosis with polyangiitis when PR3-ANCA serum levels are elevated, careful examination of the radiological findings may aid the diagnosis.