Schwannoma of the Nasal Septum: A Rare Case

Abstract

Schwannomas are benign tumors originated in the neural crests derived from Schwann cells. It is rarely seen in the nose and paranasal sinuses, and it very rarely originates from the nasal septum. We report the case of a 56 year-old male admitted to the Department of Otolaryngology-Head and Neck Surgery at Avicenna Military Hospital in Marrakesh (Morocco), with the complaint of a progressive left nasal obstruction since the last 9 months. Local examination and rigid endoscopy showed a smooth polypoid lesion completely filling the left nasal fossa, with a pedicle in the posterior septum region. Contrast enhanced computed tomography and magnetic resonance imaging suggested a benign origin. The tumor was completely removed via an endoscopic approach and histopathologic examination revealed a schwannoma.

Schwannoma of the Nasal Septum: A Rare Clinicopathological Case Report in an 18-Year-Old Female

“…[ 2 , 3 ] The first case of nasal septum schwannoma was described by Bogdasarian and Stout in 1943. [ 4 , 5 ]…”

“…In head and neck region mostly arise from 8 th cranial nerve (vestibulocochlear), never arise from optic and olfactory nerve as these nerve lack nerve sheaths which contain schwann cells. [ 5 ] On the basis of location, schwannoma are divided into nonvestibular schwannoma, extracranial head and neck schwannoma and intracranial acoustic schwannoma. Sinonasal schwannomas are rare and account only about 4% of all head and neck schwannomas.…”

“…Headache, hyposmia, nasal swelling and pain, exophthalmos, diplopia, and facial distortion were less recorded and usually implied due to extended lesions with adjacent structure involvement. [ 1 , 2 , 4 , 5 , 8 , 9 ]…”

“…Contrast-enhanced CT scan demonstrates peripheral enhancing neovascular areas and nonenhancing central necrotic or cystic area of the tumor. [ 1 , 2 , 5 ] Magnetic resonance imaging (MRI) is superior to CT in differentiating tumors from inflammatory changes and in the evaluation of their extranasal extensions. [ 1 , 2 ] Fascicular sign, seen at MRI, implies a lesion of neurogenic origin.…”

“…Intense S-100 protein positivity aid in the diagnosis. [ 1 , 2 , 5 , 9 ] There are several subtypes of schwannoma: cellular, pigmented, plexiform, and epithelioid.…”