Abstract:We report a schwannoma with a rare location at the tip of the nose in a 20-year-old woman with an otherwise unremarkable medical history. The imaging findings underline the usefulness of MRI in narrowing down the differential diagnosis of masses in this region. Once the diagnosis was focussed on a neural origin of the mass, the exact nature of the tumour could not be predicted from the MRI, although the presence of a capsule on imaging studies as well as at operation suggested it was probably a schwannoma. A s… Show more
More than 70 benign and malignant sinonasal tumours and tumour-like conditions have been described. However, sinonasal tumours are rare, and sinonasal cancers comprise only 3% of all head and neck cancers and 1% of all malignancies, with a peak incidence in the 5th to 7th decades and with a male preponderance. The early symptoms and imaging findings of sinonasal tumours are similar to rhinosinusitis with runny and stuffy nose, lacrimation and epistaxis and therefore neglected both by the patients and doctors. When late symptoms such as anosmia, visual disturbances, cranial neuropathy (Cn II, IV, V, VI) or facial swelling appear, the patient is referred to sinonasal endoscopy or imaging. At the time of correct diagnosis more than half of the tumours have reached an advanced stage with a poor prognostic outcome. Even if imaging is performed in the early stages, a radiologist inexperienced with sinonasal anatomy and tumour features may easily interpret early signs of a malignant tumour as rhinosinusitis or a lesion that does not require follow-up. This article presents the imaging findings in some of the most common benign and malignant sinonasal tumours, and the TNM classification and staging of sinonasal carcinomas.
More than 70 benign and malignant sinonasal tumours and tumour-like conditions have been described. However, sinonasal tumours are rare, and sinonasal cancers comprise only 3% of all head and neck cancers and 1% of all malignancies, with a peak incidence in the 5th to 7th decades and with a male preponderance. The early symptoms and imaging findings of sinonasal tumours are similar to rhinosinusitis with runny and stuffy nose, lacrimation and epistaxis and therefore neglected both by the patients and doctors. When late symptoms such as anosmia, visual disturbances, cranial neuropathy (Cn II, IV, V, VI) or facial swelling appear, the patient is referred to sinonasal endoscopy or imaging. At the time of correct diagnosis more than half of the tumours have reached an advanced stage with a poor prognostic outcome. Even if imaging is performed in the early stages, a radiologist inexperienced with sinonasal anatomy and tumour features may easily interpret early signs of a malignant tumour as rhinosinusitis or a lesion that does not require follow-up. This article presents the imaging findings in some of the most common benign and malignant sinonasal tumours, and the TNM classification and staging of sinonasal carcinomas.
“…Only about 70 cases have been recorded in the literature [3]. A sinonasal schwannoma can be found in many sites, including the nasal septum, paranasal sinus, tip of the nose, turbinate, and nasopharynx [4]- [7]. The presenting symptoms of the tumor are always non-specific, depending on the site of the mass [8].…”
Section: Discussionmentioning
confidence: 99%
“…Schwannoma presents as a solitary soft mass, with a high signal in the T2 weighted image in MRI. In some cases, the nerve is usually at the peripheral side of the mass [7]. These examinations promote better comprehension of the nature and the extent of the tumor.…”
According to the literature, half of the schwannoma cases occur in the head and neck areas and only less than 4% occur in the sinonasal tract. In this case, a 50-year-old male patient, Mr. Jeyapal with a-year-long progressive left side nasal obstruction and purulent rhinorrhea, is presented [1]. The CT reveals a mass filling the left nasal cavity. During surgical intervention, the mass is found to originate from the medial side of the septum anteriorly and inferiorly. The pathological examination reveals capsulated tumor with palisading cellular arrangement and high cellular density [2]. The pathological findings and nervous origin of the tumor are discussed after an extensive review of the literature.
“…A number of signs on MRI have been described including the split-fat sign, target sign and fascicular sign 4. Histology typically shows an encapsulated well-circumscribed lesion beneath the uninterrupted epidermis.…”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
