A columellar deformity caused by a congenital schwannoma

Abstract

Schwannoma is a benign neoplasm arising from Schwann cells of the peripheral nerve. It very rarely located in the nasal tip. We report two cases of congenital schwannoma of the nasal columella and discuss the surgical approach of such tumor. Case report: Case 1: An 18 year-old female was referred to us for a very slow growing tumor of the columella. The deformity had been present since the birth. The patient underwent an excision of its tumor using an open rhinoplasty approach. The histological examination revealed a schwannoma. No recurrence was found within 2 years of follow up. Case 2: A 4 month male baby presenting a congenital tumor of his columella. He underwent an excision using open rhinoplasty approach. The histological examination showed a plexiform schwannoma. Discussion: Schwannoma of the nasal tip is a benign tumor that gradually causes aesthetic and functional disorders. Congenital schwannoma of columella is an extremely rare clinical situation. Its diagnosis and treatment can pose certain challenges. The treatment is surgical excision and histological analysis of the specimen. Open rhinoplasty approach provided a good surgical exploration and a good cosmetic result on this nasal tip tumor.

A case of a schwannoma in the nasal columella

“…2,5 The differential diagnosis of the lesion includes abscess, hemangioma, fibroma, lipoma, granuloma, and mucocele. 6 Although schwannoma shows no typical findings on imaging studies, these are important when planning the surgical approach. The common findings of schwannoma on a contrast-enhanced CT scan are a mottled appearance with peripheral intensification and bony erosion with destruction.…”

“…4 To the best of our knowledge, schwannoma in the nasal columella is extremely rare as only four cases have been reported in the English-language literature. 2,5,6 We report this rare case of schwannoma in the nasal columella, with a review of the relevant literature.…”

An unusual finding of schwannoma in the columellar area—A case report

“…For lesions in the columella (or subsites adjacent to the columella e.g. nasal tip), excision with the open rhinoplasty approach (columellar incision) seems to be the ideal surgical method as reported in various cases [ 3 , 4 , 7 , 8 , 9 , 17 ] – it offers good exposure to the nasal cartilage framework, making it easier to perform modification of nasal tip deformities and asymmetry [ 18 ].…”

“…Columellar involvement is extremely rare. A literature search found only three other published cases of schwannoma involving the columella [ [3] , [4] ]. We therefore present the 4th documented case of a columellar schwannoma.…”

An interesting case of neurofibroma of face

“…It is associated with pigmented spots (coffee coloured) in the skin, commonly seen on the back, abdomen and limbs (café au lait spots). Axillary freckling and lisch nodules may be present [1,2]. Diagnostic criteria include two or more of the following [2,3]:…”