An Extensive Unilateral Nasal Mass: Septal Schwannoma—Case Report

Abstract

Schwannomas are benign peripheral nerve sheath tumours that arise from the Schwann cells of the myelinated nerve and may occur throughout the body. Paranasal schwannomas are uncommon lesions, representing less than 4% of all head and neck schwannomas and nasal septal schwannomas are very rare. Here we report a rare case of sinonasal schwannoma in a 46-yearold male who presented with a history of progressive nasal blockage of 3 years duration. The mass was removed by endoscopic approach without any postoperative complication. The rarity of diagnosis was aided by immune histopathology (IHC) of the tissue to confirm the disease.

Sinonasal schwannoma masquerading as an IgG4-related nasal mass

“…Approximately 25–45% of schwannomas arise from the head-and-neck region, but only 4% involve the sinuses 10. Ethmoids are the the most common site of occurrence, with few case reports involving sphenoid, frontal and nasal septum 11. These lesions usually arise from myelinated sensory nerves.…”

Subcutaneous Nasal Schwannoma in a Pediatric Patient: A Rare Case Report with Emphasis on Histopathology\'s Role in Differential Diagnosis

“…Schwannomas are peripheral nerve tumors that are most common in young adults [ 1 ]. Our case report is one the few of schwannoma in a pediatric patient [ 5 , 6 ], and while our patient had an asymptomatic, growing mass, other cases of nasal schwannoma in the literature presented with isolated nasal obstruction [ 2 , 7 , 8 ], accompanied by anosmia or voice changes [ 4 ] and epistaxis [ 9 , 10 ].…”

“…The surgical procedure depends on the tumor size, location, and invasion of adjacent structures [ 10 ]. Several surgical techniques are discussed in the literature, including open septorhinoplasty [ 7 ], lateral rhinotomy [ 10 ], and endonasal endoscopic excision [ 2 , 4 ], with latter considered the standard surgical approach [ 1 ].…”

“…Common reported symptoms include nasal obstruction, epistaxis, and rhinorrhea, but some patients also present with facial pain, anosmia, and proptosis [ 3 ], although imaging modalities can be useful to assess the origin and extent of the tumor. The final diagnosis of schwannoma must be confirmed by histopathology [ 4 ].…”