Sinonasal Schwannoma: A Case Report and Updated Review of the Literature

Abstract

Sinonasal schwannomas are rare, benign and slow-growing peripheral nerve sheath tumors without age, race, or gender predilection. We present the unusual case of a 59-year-old female who presented with right-sided retro-orbital pressure and rhinorrhea. Radiographic imaging revealed a mass centered in the right superior nasal cavity with extension through the cribriform plate into the right more than the left subfrontal region. Biopsy confirmed the diagnosis of a sinonasal schwannoma, which was resected via nasal endoscopic surgery and ethmoidectomy. These tumors, albeit rare, should be considered in the differential diagnosis for patients presenting with a paranasal sinus mass to ensure inclusion of this benign lesion and avoid unnecessary aggressive intervention.

A Rare Case of Nasal Schwannoma of Middle Turbinate

“…Some cases with intracranial extension have also been reported in literature. 1 Sphenoid sinus schwannomas may present with nerve palsies leading to diplopia and blurring of vision. 6 CT shows size, extend of lesion and surrounding bone erosion.…”

“…Approximately 25-45% of schwannomas occur in the head and neck and only about 4% of these last arise in the sinonasal tract. 1 Within the sinonasal tract, the ethmoidal sinus is the most commonly involved site, followed by the maxillary sinus, nasal fossa, and sphenoid sinus. Frontal sinus involvement is extremely rare, and has been reported in very few cases.…”

Schwannomas of Ear, Nose, Throat and Neck

“…Sinonasalcavity and intraoral schwannomas contribute only 4% and 1% of head and neck Schwannomasrespectively. 5,6 Schwanommas are usually asymptomatic. Symptoms of nerve involvement appear very late due to compression of nerve of origin.…”