Schwannoma of the nasal septum: a case report with review of the literature

Abstract

Schwannomas are neurogenic neoplasms rarely found in the sinonasal tract, where localization to the nasal septum is exceedingly rare (only 11 cases have been described in the western literature). We report the case of a 29-year-old white male with a schwannoma completely filling the left nasal fossa and arising from the bony part of the septum. A computer tomography (CT) scan and a biopsy suggestive of benign schwannoma were obtained before the lesion was removed by a degloving approach. The preoperative diagnosis of nasal septum schwannoma was confirmed. The patient is asymptomatic and without endoscopic evidence of recurrence 7 years after surgery. A review of the literature with particular emphasis on the clinical presentation, histological features, differential diagnosis and therapeutic options for such a rare lesion is included.

Nasal septal schwannoma

“…[2,3] Since optic and olfactory nerves do not contain schwann cells, schwannomas are not encountered on these nerves. [5] Head and neck schwannomas have been suggested to originate most frequently from opthalmic, and maxillary branches of the vestibular, and trigeminal nerves. [6] We think that in our case tumor stemmed from autonomic, and sensorineural nerve fibers innervating nasal septum.…”

“…Similar female/male ratios have been reported without any difference between races. [5] Schwannomas have been frequently associated with von Recklinghausen disease, and malignant potential of these tumors have been occasionally demonstrated. [7] Clinical findings are generally variable.…”

Only Septal Deviation? A Tiny Schwannoma in the Nasal Septum

“…25-45 % of such tumors are in the head and neck region. Exactly, involvement of the nose and paranasal sinus is rare, with only sporadic cases having been reported in the world [7,9,11]. Especially, nasal septum involvement is also quite rare, and there are only a few numbers of these schwannomas reported in the literatures.…”

“…Patients' chief complaint may include nasal obstruction, epistaxis, rhinorrhoea, anosmia, or facial swelling and pain [6,7]. The clinical presentation of a schwannoma can also be hypoesthesia or paresthesia that is caused by the compression of the involved nerve by tumor [7,9]. It is very important to antidiastole with septal deviation, chronic sinusitis and other up-airway diseases.…”

“…It can arise throughout all parts of the body. Although it is not uncommon to find schwannomas in the head and neck region, this disease is comparatively rare in the nasal cavity and paranasal sinuses, previously reported multiple lesions involving the paranasal sinuses or nasal mucosa [1][2][3][4][5][7][8][9]. Herein we report the scarce case of nasal septum schwannoma without any lesion involving both mucosa and paranasal sinuses, which the out-patient diagnosis was septal deviation only.…”