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Diagnostic and Treatment Challenges in Neurofibroma of External Nose. The Journal of Laryngology & Otology 2021; 136:473-478. [PMID: 34906268 DOI: 10.1017/s0022215121004126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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2
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Liu D, Mu Y, Chen P, Che B, Li Z, Zhao Y, Sun F, Tang K. Rare primary malignant peripheral nerve sheath tumor of the left testis: A case report. Mol Clin Oncol 2021; 15:144. [PMID: 34094542 PMCID: PMC8165690 DOI: 10.3892/mco.2021.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 04/09/2021] [Indexed: 11/09/2022] Open
Abstract
Malignant peripheral nerve sheath tumor (MPNST) is a rare disease. The present study discusses the case of a 30-year-old male patient who presented with complaints of pain in the left testis and groin over 1 month. Ultrasonography and computed tomography (CT) imaging revealed the presence of a space-occupying lesion localized in the left testis. The mass was completely resected using an open surgical approach and was diagnosed as a primary MPNST of the left testis on postoperative histopathological examination. As this type of tumor is rare, there is currently no standard diagnostic or treatment method for MPNST. Pathological examination, enhanced CT imaging and immunohistochemical investigation are helpful for establishing the diagnosis and surgical resection is considered to be an effective treatment.
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Affiliation(s)
- Dongdong Liu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Yi Mu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Pan Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Bangwei Che
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Zheming Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Yili Zhao
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Fa Sun
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Kaifa Tang
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China.,Institute of Medical Science of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
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3
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Yoon SH, Kim CS, Oh JW, Lee KC. Schwannoma on the nasal dorsum and tip with sensory changes. Arch Craniofac Surg 2020; 21:380-383. [PMID: 33663149 PMCID: PMC7933723 DOI: 10.7181/acfs.2020.00416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/08/2020] [Indexed: 11/11/2022] Open
Abstract
Schwannomas, which originate from Schwann cells in the peripheral nervous system, are slowgrowing and uncommon benign tumors. Most schwannomas (90%) occur in isolation, and multiple occurrences are a characteristic feature of neurofibromas. Schwannomas of the nose and nasal tip are particularly unusual. Although a few cases of schwannomas of the sinusoidal tract and nasal septum have been reported, schwannomas arising from the nasal dorsum area and tip are extremely rare. Sensory abnormalities are also a very rare symptom. We excised a schwannoma on the nasal dorsum through direct incision and a schwannoma on the nasal tip through open rhinoplasty. No postoperative complications involving recurrence, hematoma, or infection occurred. The possibility of neurological changes should be considered in cases of an abnormality in the peripheral nervous system. Schwannoma must be kept in mind as a possible cause of neurological changes localized to a specific dermatome, and should always be considered in the differential diagnosis of a mass on the nose.
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Affiliation(s)
- Sung Ho Yoon
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Cha Soo Kim
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jae Wook Oh
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Keun Cheol Lee
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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4
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A Rare and Unexpected Reason for Unilateral Epistaxis: Nasal Septal Schwannoma. Case Rep Otolaryngol 2020; 2020:4369620. [PMID: 33101747 PMCID: PMC7569445 DOI: 10.1155/2020/4369620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022] Open
Abstract
Nasal septal schwannoma is a rare tumor. It causes complaints such as nasal congestion, nosebleeds, and headaches. There are many diseases such as nasal polyps, antrochoanal polyp, chronic rhinosinusitis, concha bullosa, inverted papilloma, and retention cyst with schwannoma diagnosis. The diagnosis is made histopathologically, and the treatment is surgery. In this case report, we presented a male patient with septal schwannoma who had nasal obstruction for a year and reviewed the last 20 years of literature on nasal schwannoma.
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5
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Kapitanov DN, Satanin LA, Chernikova NA, Shishkina LV, Shelesko EV, Arustamyan SR, Bukharin EY. [Nasal schwannoma with skull base destruction in a child (a case report and literature review)]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2019; 82:100-106. [PMID: 29795093 DOI: 10.17116/oftalma2018822100-106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Schwannomas (neurinomas) are benign, encapsulated, and slow-growing neoplasms developing from any peripheral, cranial, or vegetative nerve that has the Schwann sheath. Schwannomas of the nasal cavity and paranasal sinuses in adults occur rarely, less than 4% of cases. The world literature lacks similar data for the pediatric age group because these tumors in children are unique and extremely rare. The most common clinical symptoms of sinonasal schwannoma are nasal breathing disorders, hyposmia or anosmia, and snoring at night. Other symptoms are associated with intranasal schwannoma invasion of neighboring organs and tissues and include exophthalmos, epiphora (lacrimation), headaches, and anesthesia in the facial area. In this article, we describe a rare case of diagnosis and successful surgical treatment of a child with intranasal schwannoma destructing the skull base.
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Affiliation(s)
- D N Kapitanov
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - L A Satanin
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - N A Chernikova
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - L V Shishkina
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - E V Shelesko
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - S R Arustamyan
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - E Yu Bukharin
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
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6
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Sandler ML, Sims JR, Sinclair C, Sharif KF, Ho R, Yue LE, Téllez MJ, Ulkatan S, Khorsandi AS, Brandwein-Weber M, Urken ML. Vagal schwannomas of the head and neck: A comprehensive review and a novel approach to preserving vocal cord innervation and function. Head Neck 2019; 41:2450-2466. [PMID: 30957342 DOI: 10.1002/hed.25758] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Schwannomas, benign tumors arising from neurolemmocytes, are the most common type of peripheral nerve tumors. Extracranial schwannomas are most often found in the parapharyngeal space, commonly involving the vagus nerve to cervical sympathetic trunk. Vagal schwannomas present several unique clinical and therapeutic challenges. METHODS A comprehensive literature review was conducted on 197 articles reporting 235 cases of cervical vagal schwannomas. Presenting symptoms, treatment approach, and postoperative outcomes were recorded and analyzed. RESULTS Vagal schwannomas commonly present as asymptomatic neck masses. When they become symptomatic, surgical resection is the standard of care. Gross total resection is associated with higher postoperative morbidity compared to subtotal resection. Initial reports using intraoperative nerve monitoring have shown improved nerve preservation. Recurrence rates are low. CONCLUSION The combination of intermittent nerve mapping with novel continuous vagal nerve monitoring techniques may reduce postoperative morbidity and could represent the future standard of care for vagal schwannoma treatment.
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Affiliation(s)
- Mykayla L Sandler
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - John R Sims
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Catherine Sinclair
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kayvon F Sharif
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - Rebecca Ho
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - Lauren E Yue
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York
| | - Maria J Téllez
- Department of Intraoperative Neurophysiology, Mount Sinai West Hospital, New York, New York
| | - Sedat Ulkatan
- Department of Intraoperative Neurophysiology, Mount Sinai West Hospital, New York, New York
| | - Azita S Khorsandi
- Department of Radiology, New York Eye & Ear Infirmary of Mount Sinai, New York, New York
| | | | - Mark L Urken
- THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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7
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Alrasheed W, Almomen A, Alkhatib A. A rare case of nasal septal schwannoma: Case report and literature review. Int J Surg Case Rep 2019; 55:149-151. [PMID: 30738369 PMCID: PMC6370567 DOI: 10.1016/j.ijscr.2019.01.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 11/24/2022] Open
Abstract
Schwannoma is a benign nerve sheath tumor that can arise from any myelinated nerve fiber. Nasal septal schwannoma is rare, and only 32 cases have been reported in the literature. The diagnosis of the nasal septal schwannoma primarily depends on histopathological examination. Endoscopic endonasal excision of the mass is considered the ideal treatment for such pathology, with rare postoperative recurrence.
Introduction: Sinonasal schwannoma accounts for only 4% of head and neck nerve sheath tumors. Schwannoma of the nasal septum is still the rarest, with only few cases previously reported. Case presentation: This study presents the case of a 64-year-old Saudi female of the Eastern Province who presented a several-month history of unilateral progressive nasal obstruction and recurrent episodes of epistaxis. The diagnosis of nasal septal schwannoma was made on the basis of a histopathological examination. The case was managed successfully by endoscopic endonasal excision with no postoperative recurrence. Discussion: Nasal septal schwannoma is rare and has only 32 reported cases. Diagnosis primarily depends on histopathological examination. Endoscopic endonasal excision of the mass is considered the ideal treatment for such pathology. Conclusion: Schwannoma of the nasal septum is rare. However, it should be included as a differential diagnosis in a patient presenting with a unilateral nasal mass.
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Affiliation(s)
| | - Ali Almomen
- Department of ENT, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
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8
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Schwannoma of the Membranous Nasal Septum: a Clinical Report With Aesthetic Approach. J Craniofac Surg 2018; 29:e120-e122. [PMID: 29381644 DOI: 10.1097/scs.0000000000004092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Schwannoma is an uncommon tumor of nerve sheath that arises from any peripheral, cranial, or autonomic nerve. Only 4% of head and neck schwannomas originate from the sinonasal tract, and a finding of a schwannoma in the nasal septum is exceedingly rare. The authors experienced nasal septal schwannoma with the functional and aesthetic consideration of nasal contour. The authors present an open rhinoplasty approach for nasal septal schwannoma which has not been reported in the previous literature yet.
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9
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Abstract
Schwannoma (neurilemmoma) is a benign tumour that arises from the Schwann cells which cover the nerve sheaths of the peripheral or autonomic nervous system especially the sympathetic system. Reported cases of schwannoma arising from the sinonasal tract are rare. We report a case of a 28-year-old man who presented to otolaryngology-head and neck surgery clinic with left cheek swelling and left-sided nasal obstruction for 1-year period. Endoscopic examination and high-resolution CT scan revealed a homogenous expansile mass occupying the left maxillary antrum extending to the left orbit and left ethmoidal air cells. The mass was excised through endoscopic endonasal approach followed by Caldwell-Luc approach for the residual tumour. Postoperative histopathological examination revealed benign type Antoni A schwannoma.
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Affiliation(s)
- Bader Mohammed Alim
- Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Jomah
- Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Majid Al-Thobaiti
- Department of Otolaryngology-Head and Neck Surgery, Security Forces Hospital Program, Riyadh, Saudi Arabia
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10
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Kandasamy S, Nathan RS, John RR. Neurilemmoma of Maxillary Alveolus: A Rare Case Report and Review of Literature. J Pharm Bioallied Sci 2017; 9:S285-S288. [PMID: 29284981 PMCID: PMC5731032 DOI: 10.4103/jpbs.jpbs_114_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannomas account for 1% of head and neck region and are commonly seen at the base of the tongue. Most of the literature, reports of schwannomas in the tongue region are common. In this article we report a rare occurrence of schwannoma in the maxillary alveolus region and its management. A 45 year old female patient reported to the department of oral and maxillofacial surgery with a complaint of swelling in the left maxillary alveolus in relation to molar teeth that had been present for more than 3 months. Apparently the swelling was small one initially, which gradually increased in size. Such a rare cas e of intraoral schwannoma should be followed up periodically to look for any malignant transformation and recurrences. An important conclusion that has evolved from the reviewed articles, is that the differential diagnosis of painless nodules in head and neck must include schwannomas.
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Affiliation(s)
- Saravanan Kandasamy
- Department of Oral and Maxillofacial Surgery, Vinayaka Missions Sankarachariyar Dental College and Hospital, Salem, Tamil Nadu, India
| | - R Senthil Nathan
- Consultant Oral and Maxillofacial Surgeon, Vasan Dental Care, Erode, Tamil Nadu, India
| | - Reena Rachel John
- Department of Oral and Maxillofacial Surgery, Vinayaka Missions Sankarachariyar Dental College and Hospital, Salem, Tamil Nadu, India
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11
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Abstract
Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3rd cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case.
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Affiliation(s)
- Oshin Hegde
- Department of Oral Medicine and Radiology, A.J. Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Dinkar Desai
- Department of Oral Pathology, A.J. Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Gowri P Bhandarkar
- Department of Oral Medicine and Radiology, A.J. Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Tony Paul
- Department of Oral Pathology, A.J. Institute of Dental Sciences, Mangalore, Karnataka, India
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12
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Karligkiotis A, Turri-Zanoni M, Sica E, Facco C, Freguia S, Mercuri A, Pistochini A, Bignami M, Castelnuovo P. Role of endoscopic surgery in the management of sinonasal and skull base schwannomas. Head Neck 2016; 38 Suppl 1:E2074-82. [PMID: 26876981 DOI: 10.1002/hed.24383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to report our experience with the endoscopic management of sinonasal schwannomas, analyzing the advantages, limitations, and outcomes of the technique. METHODS A retrospective analysis was carried out on 11 patients treated endoscopically between 2000 and 2014 at a single institution. RESULTS Eight patients underwent an exclusive endoscopic endonasal approach, whereas, in 3 patients, an osteoplastic flap was combined because of massive or lateral frontal sinus involvement. The tumor extended into the orbit in 5 cases, and involved the skull base in 5 patients who required a concomitant endoscopic duraplasty. No evidence of disease was observed in 10 patients after a mean follow-up of 90.1 months (range, 14-189 months). One patient was alive with persistence of disease, although asymptomatic. CONCLUSION The endoscopic endonasal approach is a valid alternative for the vast majority of sinonasal schwannomas with minimal morbidity for the patient. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2074-E2082, 2016.
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Affiliation(s)
- Apostolos Karligkiotis
- Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.,Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.,Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.,Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Eleonora Sica
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Carla Facco
- Division of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - Stefania Freguia
- Division of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - Anna Mercuri
- Department of Neuroradiology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Andrea Pistochini
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.,Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.,Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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13
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Nataraj RV, Jagade M, Parelkar K, Hanawte R, Singhal A, Rengaraja D, Kulsange K, Rao K, Gupta P. Plexiform Neurofibroma of Nasal Tip. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ijohns.2015.46068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Gulia JS, Yadav SS, Basur SK, Hooda A. Schwannoma of the membranous nasal septum. Braz J Otorhinolaryngol 2014; 79:789. [PMID: 24474492 PMCID: PMC9442333 DOI: 10.5935/1808-8694.20130140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 07/10/2013] [Indexed: 11/20/2022] Open
Affiliation(s)
- Joginder Singh Gulia
- Departamento de Otorrinolaringologia, Pt. B.D Sharma University of Health Sciences Rohtak, Haryana, Índia
| | - Samarpal Singh Yadav
- Departamento de Otorrinolaringologia, Pt. B.D Sharma University of Health Sciences Rohtak, Haryana, Índia
| | - Sukhdeep Kaur Basur
- Departamento de Otorrinolaringologia, Pt. B.D Sharma University of Health Sciences Rohtak, Haryana, Índia
| | - Anita Hooda
- Departamento de Anatomia Oral, Pt. B.D Sharma University of Health Sciences Rohtak, Haryana, Índia
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15
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Nerve-sparing subcapsular resection of head and neck schwannomas: technique evaluation and literature review. The Journal of Laryngology & Otology 2013; 127:685-90. [DOI: 10.1017/s0022215113001102] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:The head and neck region harbours crucial structures and hence the surgical technique used to remove schwannomas from this region should cause minimal damage to these structures, with complete removal of pathology.Methods:This study entailed a retrospective analysis of 10 patients with head and neck schwannomas that were excised using a nerve-sparing subcapsular dissection technique. The primary aims were to assess the functional impact of the surgical technique on the structure of origin and to evaluate local control.Results:One patient with parapharyngeal schwannoma developed symptoms suggestive of ‘first bite syndrome’ in the late post-operative period. Another patient with facial nerve schwannoma had House–Brackmann grade II weakness in the immediate post-operative period, which subsequently resolved. None of the patients developed recurrence during a median follow-up period of two years.Conclusion:The nerve-sparing subcapsular dissection technique provided effective local control of tumour pathology, with relative preservation of neural function post-operatively.
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16
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Hazarika P, Nayak DR, Pujary K, Rao L. Schwannoma of the nose and paranasal sinuses. Indian J Otolaryngol Head Neck Surg 2012; 55:34-8. [PMID: 23119934 DOI: 10.1007/bf02968752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Sckhwannoma is a benign tumor arising from the Schwann cells of nerve sheath.Through they arise more commonly in the head and neck than other regions, a through search in the liturature including medline revealed only about 47 reported cases of schwannoma in the paranasal sinuses of which the maxillary sinus involvement is more common. We report three cases of schwannoma arising from unusual sites in the paranasal sinuses with different modes of presttation each requiring a specific approach for surgical excision Transnasal endoscopic approach in combination with vonventional approaches is of immense value in the surgical management of these benign lessions of the paranasal sinuses.
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Affiliation(s)
- P Hazarika
- Department of ENT-Head & Neck Surgery, Kasturba Medical College, 576 119 Manipal, Karnataka, India
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17
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Khanna S, Gupta SC, Singh PA. Schwannoma of maxillary sinus. Indian J Otolaryngol Head Neck Surg 2012; 55:132-5. [PMID: 23119962 DOI: 10.1007/bf02974623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Schwannoma, also known as neurilemmoma, is a solitary, encapsulated peripheral tumour of neuroectodermal derivation that originates from schwann cells of neural sheath of motor/ sensory peripheral nerves or sympathetic nerves. About one- third of all schwannomas occur in head and neck region but nose and paranasal sinuses, are rare sites. We report a case of schwannoma arising from the maxillary sinus and eroding the orbital floor. To the best of our knowledge, this is the sixth; case of schwannoma solely arising in the maxillary sinus, reported in the literature.
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Affiliation(s)
- Sanjay Khanna
- Department of ENT, MLN Medical College, 211001 Allahabad, India
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18
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Mitra B, Debnath S, Paul B, Pal M, Banerjee TJ, Saha TN. Schwannoma of nasal septum: A rare case report with literature review. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ejenta.2012.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Hu J, Bao YY, Cheng KJ, Zhou SH, Ruan LX, Zheng ZJ. Computed tomography and pathological findings of five nasal neurilemmomas. HEAD & NECK ONCOLOGY 2012; 4:26. [PMID: 22621416 PMCID: PMC3448516 DOI: 10.1186/1758-3284-4-26] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 05/08/2012] [Indexed: 11/11/2022]
Abstract
Objectives Neurilemmomas are benign tumors deriving from Schwann cells of the nerve sheath. They occur in all parts of the body. The highest incidence of neurilemmoma is in the head and neck region (38–45%), but involvement of the nose and paranasal sinus is quite rare, with only sporadic cases having been reported in the world literature. Fewer than 4% of these tumors involve the nasal cavity and paranasal sinuses. We describe the clinical, pathologic, and computed tomography (CT) features of five nasal neurilemmomas. Methodology CT features of five patients with nasal schwannoma proved by operation and pathology were investigated. Results Schwannomas tend to be solitary and are usually well-circumscribed tumors with an oval, round or fusiform shape in the unilateral nasal cavity. The lesions usually have a mottled central lucency with peripheral intensification on contrast-enhanced CT scans. The heterogeneous appearance is related to areas of increased vascularity with adjacent non-enhancing cystic or necrotic regions. Conclusions Schwannoma should be considered in the differential of unusual nasal masses. Certain clinical and CT patterns may be of use in the differential diagnosis.
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Affiliation(s)
- Jing Hu
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Gupta SC, Sachin J, Savyasachi S, Ritesh J, Neha G, Singh HP. Solitary nasal schwannoma clinically presenting as an angiofibroma of the nasopharynx. EAR, NOSE & THROAT JOURNAL 2010; 89:E28-30. [PMID: 20628976 DOI: 10.1177/014556131008900706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Benign schwannomas of the nasal cavity are rare. When they do occur, their clinical presentation is variable, and some are fairly vascular. We report the case of a 17-year-old boy who presented with epistaxis associated with a unilateral nasal mass that extended into the nasopharynx. The tumor was removed via a transpalatal approach. In most such cases, a clinical diagnosis of angiofibroma is made. In this case, however, histopathologic examination identified the lesion as a schwannoma.
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Affiliation(s)
- S C Gupta
- Department of Otorhinolaryngology-Head and Neck Surgery, Moti Lal Nehru Medical College, Allahabad-211001, UP, India.
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Ramavat A, Kumar R, Venkatakarthikeyan C, Jain A, Deka RC. Modified lateral rhinotomy for fronto-ethmoid schwannoma in a child: a case report. CASES JOURNAL 2010; 3:64. [PMID: 20167093 PMCID: PMC2838854 DOI: 10.1186/1757-1626-3-64] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 02/18/2010] [Indexed: 11/10/2022]
Abstract
Schwannoma of frontoethmoid region is a rare presentation. We report a case of 11-year-old girl with a swelling at the root of nose and nasal dorsum. Based on clinical picture and radiological findings it was not possible to establish a definitive diagnosis. But the histopathological picture was suggestive of schwannoma. A novel surgical approach was adopted to facilitate complete removal of the tumor and provide best possible cosmetic results.
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Affiliation(s)
- Anurag Ramavat
- Department of Otorhinolaryngology & Head & Neck Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India.
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Somasekhar, Lakshmi S, Ramya S. Sinonasal schwannoma with secondary changes. Indian J Otolaryngol Head Neck Surg 2008; 60:274-6. [PMID: 23120562 PMCID: PMC3450631 DOI: 10.1007/s12070-008-0092-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Schwannomas of the Sinonasal tract are very rare, representing less than 4% of schwannomas arising in the head and neck [1]. The most frequent site is the acoustic nerve; other locations include the scalp, oral cavity, pharynx, larynx, trachea, parotid gland, and middle ear. Secondary changes in a Schwannoma are a very rare entity. We report a case of Sinonasal schwannoma with pseudoangiomatous changes. The purpose of this article is to highlight the possibility of unusual presentation of a sinonasal schwannoma.
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Sheikh HY, Chakravarthy RP, Slevin NJ, Sykes AJ, Banerjee SS. Benign schwannoma in paranasal sinuses: a clinico-pathological study of five cases, emphasising diagnostic difficulties. The Journal of Laryngology & Otology 2007; 122:598-602. [PMID: 17705894 DOI: 10.1017/s0022215107000527] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To highlight the difficulty in making a correct diagnosis of benign schwannoma in the paranasal region, to raise awareness of this rare condition, and to suggest the most appropriate treatment. METHOD Retrieval of cases retrospectively from archives of the histopathology department of a major UK cancer centre with central review of all cases. RESULTS Five cases were identified since 1990 and clinical and pathological features are summarised. Median follow up of patients was 8.1 years. Radiological appearances of local bone invasion and histological features of tumour unencapsulation and hypercellularity could give the mistaken impression of malignant disease and lead to unnecessary over-treatment. CONCLUSION Central pathological review and clinical awareness is required. Although local recurrence can occur, the prognosis is excellent. The treatment of choice is local excision. Radiotherapy can be considered, but in most cases it would incur unnecessary morbidity.
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Affiliation(s)
- H Y Sheikh
- Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.
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25
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Solitary plexiform neurofibroma of the nasal tip: Case report and review of the literature. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.pedex.2007.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Malone JP, Lee WJ, Levin RJ. Clinical characteristics and treatment outcome for nonvestibular schwannomas of the head and neck. Am J Otolaryngol 2005; 26:108-12. [PMID: 15742263 DOI: 10.1016/j.amjoto.2004.08.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Studies involving head and neck schwannomas have focused predominantly on involvement of the vestibulocochlear nerve complex (acoustic neuroma) because of the associated morbidity related to lesions involving that region. However, the majority of head and neck schwannomas are not of vestibular nerve origin and may also produce significant morbidity due to involvement of the orbit, skull base, and cranial nerves. The purpose of this study is to examine the presenting signs and symptoms, location, nerve of origin, and outcome after treatment of patients with nonvestibular schwannomas of the head and neck. MATERIALS AND METHODS The medical and pathological records of all patients with nonvestibular head and neck schwannomas treated at a single institution between 1979 and 1999 were retrospectively reviewed. RESULTS Eighteen (69%) of 26 patients presented with symptoms secondary to mass effect or nerve deficit. The parapharyngeal space was the most common site of tumor origin occurring in 8 patients (31%). The nerve of origin was identified in 16 patients (62%). Twenty-three patients (88%) had complete surgical excision, and 3 patients (12%) had subtotal resection. Postoperative nerve injury occurred in 16 patients (62%) with resolution in 7 patients (44%). CONCLUSIONS Nonvestibular head and neck schwannomas occur most commonly in the parapharyngeal space, and presenting signs or symptoms are usually related to mass effect or neural deficit. Complete tumor removal is often achieved, but subtotal or near-total resection may be indicated for patients with extensive skull base, middle ear, or facial nerve involvement. Postoperative morbidity is associated with nerve injury from the surgical approach and/or resection of the involved nerve.
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Affiliation(s)
- James P Malone
- Division of Otolaryngology-Head and Neck Surgery, Penn State University College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
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Buob D, Wacrenier A, Chevalier D, Aubert S, Quinchon JF, Gosselin B, Leroy X. Schwannoma of the sinonasal tract: a clinicopathologic and immunohistochemical study of 5 cases. Arch Pathol Lab Med 2003; 127:1196-9. [PMID: 12946223 DOI: 10.5858/2003-127-1196-sotsta] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Peripheral nerve sheath tumors are soft tissue neoplasms rarely encountered in the nasal cavity and paranasal sinuses. OBJECTIVE To describe the clinicopathologic and immunohistochemical features of a series of schwannomas of the sinonasal tract. DESIGN Surgical pathology files were searched for the diagnosis "sinonasal schwannoma." All histologic documents and clinical data were reviewed. Immunohistochemistry was performed on paraffin-embedded tissue with antibodies to S100 protein, epithelial membrane antigen, CD34, and MIB-1. RESULSTS: Five cases of sinonasal schwannoma were retrieved; patients included 3 women and 2 men, aged 20 to 56 years. Three cases were located in the ethmoid sinus. Clinical symptoms were nonspecific (nasal obstruction, epistaxis, and anosmia). All tumors were treated with conservative surgical resection. Pathologic examination showed a spindle cell proliferation without encapsulation in all cases. No cytologic atypia was seen, and the mitotic activity was low (<3 mitotic figures/10 high-power fields). Immunohistochemistry showed diffuse positivity with S100 protein and negativity with CD34 and epithelial membrane antigen. MIB-1 staining was low (1%-5% of tumor cell nuclei stained). During the follow-up (median, 6 years), no recurrence or metastasis was observed. CONCLUSIONS Schwannoma is a very unusual tumor of the sinonasal tract and is associated with nonspecific symptoms. Histologically, sinonasal schwannomas differ from schwannomas of other locations by their lack of a peripheral capsule and possible ulceration of the epithelial covering. Sinonasal schwannomas are treated with conservative surgical resection and have an excellent prognosis.
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Affiliation(s)
- David Buob
- Department of Pathology, Centre Hospitalier Regional Universitaire de Lille, France
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Al-Otieschan AT, Manohar MB, Gangopadhyay K, Tulbah A. Cellular Schwannoma of the Paranasal Sinuses: Initial Report of a Case. EAR, NOSE & THROAT JOURNAL 2002. [DOI: 10.1177/014556130208100418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cellular schwannomas are a benign variant of classic schwannomas. Their histologic appearance closely mimics that of malignant peripheral nerve-sheath tumors, which are high-grade sarcomas. In this article, we describe what to our knowledge is the first reported case of a cellular schwannoma of the paranasal sinuses and only the 33rd reported case of any schwannoma at this site. We also discuss the histology and management of cellular schwannomas and review the pertinent literature.
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Affiliation(s)
- Abdullah T. Al-Otieschan
- Department of Otolaryngology-Head and Neck Surgery and Communication Sciences, Riyadh, Saudi Arabia
| | - Manirajulu Babu Manohar
- Department of Otolaryngology-Head and Neck Surgery and Communication Sciences, Riyadh, Saudi Arabia
| | - Kunal Gangopadhyay
- Department of Otolaryngology-Head and Neck Surgery and Communication Sciences, Riyadh, Saudi Arabia
| | - Asma Tulbah
- Department of Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Schwartz TH, Bruce JN. Extended frontal approach with bilateral orbitofrontoethmoidal osteotomies for removal of a giant extracranial schwannoma in the nasopharynx, sphenoid sinus, and parapharyngeal space. SURGICAL NEUROLOGY 2001; 55:270-4. [PMID: 11516465 DOI: 10.1016/s0090-3019(01)00419-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although parapharyngeal schwannomas are not uncommon, schwannomas of the nasopharynx and paranasal sinuses are rare lesions. In the absence of intracranial extension, they are usually removed with transantral, lateral rhinotomy or more complex transfacial approaches. CASE DESCRIPTION We report a 24-year-old patient with a giant benign schwannoma involving the superior parapharyngeal space, pterygopalatine fossa, nasopharynx, and sphenoid sinus with erosion into the clivus that was removed with an extended frontal approach including bilateral orbitofrontoethmoidal osteotomies. CONCLUSION The advantages of the extended subfrontal over more standard transfacial approaches for lesions in this location include the early dissection of critical neural structures, preserving cosmetics and facilitating management of an inadvertent cerebrospinal fluid leak.
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Affiliation(s)
- T H Schwartz
- Department of Neurological Surgery, New York Presbyterian Hospital, New York, New York 10021, USA
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Abstract
Within the head and neck region, neurilemmomas are rarely found in the nasal cavity or paranasal sinuses. A 70-year-old man presented with complaints of left-sided epiphora, rhinorrhea, epistaxis, and transient diplopia. Nasal endoscopy showed a large necrotic mass filling the left middle meatus. A computed tomography scan showed a large left ethmoid mass, with erosion of the medial wall of the orbit and the anterior cranial base. Multiple biopsies were nondiagnostic. Complete excision of the tumor was performed with endoscopic techniques. Small dural defects were repaired with a middle turbinate mucosal flap. Postoperatively, the patient was treated with nasal packing and a lumbar spinal drain. Final pathology showed a benign neurilemmoma. There has been no evidence of recurrence or cerebrospinal fluid leakage in follow-up. A review of the literature shows a similar presentation of patients with neurilemmomas of the paranasal sinuses. Bony destruction and intracranial extension is viewed. Lack of encapsulation and locally destructive growth in an otherwise histologically typical neurilemmoma should not suggest malignant potential. Many benign tumors of the paranasal sinuses with bone destruction may be removed by using endoscopic techniques.
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Affiliation(s)
- H M Hegazy
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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Abstract
Schwannomas, arising from the Schwann cells of the nerve sheath, occur very rarely in the sino-nasal tract and histological diagnosis can, sometimes, be difficult. We describe a case of schwannoma of the sphenoidal sinus occurring in a 71-year-old man, who underwent complete excision of the tumour endoscopically. To our knowledge, this is the third case of sphenoid sinus schwannoma reported in the English literature.
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Affiliation(s)
- V Srinivasan
- Department of Otolaryngology, Leighton Hospital, Crewe, UK.
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Sharma R, Tyagi I, Banerjee D, Pandey R. Nasoethmoid schwannoma with intracranial extension. Case report and review of literature. Neurosurg Rev 1998; 21:58-61. [PMID: 9584288 DOI: 10.1007/bf01111487] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Schwannomas are very rare in the nose and paranasal sinuses; their presence both intra-and extracranially is still rarer. Here we present a case of nasoethmoid schwannoma with intracranial extension into anterior cranial fossa. Clinical, radiological, pathological and operative findings are discussed and the literature is reviewed. We recommend bifrontal craniotomy for removal of intracranial and nasoethmoid extensions of this tumor.
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Affiliation(s)
- R Sharma
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, India
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Boyd JH, Dalsaso TA, Bee CS, Smith KR, Martin DS. Subfrontal schwannoma with intracranial mucocele: a case report. Am J Otolaryngol 1997; 18:72-5. [PMID: 9006682 DOI: 10.1016/s0196-0709(97)90053-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J H Boyd
- Department of Otolaryngology-Head and Neck Surgery, St Louis University Health Science Center, MO 63110-0250, USA
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