A Rare Laryngeal Schwannoma in an 11-Year-Old Boy

Schwannomas account for a large proportion of tumors in the head and neck regions; however, schwannomas of the larynx are rare. An 11-year-old boy had a sore throat for one month, and his symptoms gradually worsened such that he needed to visit our otolaryngology clinic. The preoperative investigation revealed a smooth mass in the left arytenoid cartilage. Endoscopy-assisted transoral resection of laryngeal masses was performed under general anesthesia, and the resected tissue was histopathologically diagnosed as a laryngeal schwannoma. The postoperative recovery was very good. During the 1-year follow-up, there was no recurrence of the schwannoma or related symptoms. Although laryngeal schwannomas are rare, they should be considered in the differential diagnosis of these tumors. Sufficient preoperative imaging should be performed before surgical resection, and surgery is the preferred treatment option.

Diagnosis and Treatment of Laryngeal Schwannoma: A Systematic Review

Objective

This review summarizes the clinical features, diagnostic workup, and surgical treatment of laryngeal schwannoma with the aim of providing guidance for the management of this rare disease. The collated data allowed the statistical testing of several hypotheses, including the efficacy of endoscopic vs open surgical intervention and the usefulness of preoperative biopsy.

Data Sources

PubMed, Google Scholar, Cochrane, and SCOPUS.

Review Methods

Basic epidemiological and clinical presentation data were collated together with details of diagnostic image modality, lesion attributes, and the use of preoperative biopsy. Surgical approach to intervention and outcome was also collated and simple statistical analyses applied.

Results

The 60 original articles selected provided a combined cohort of 74 patients for review. The combined data revealed that schwannoma with pedunculated morphology were always safely removed by endoscopic resection regardless of size and should be treated as a separate entity. Of the nonpedunculated schwannoma, larger tumors were more likely to undergo an open approach, which in turn was associated with higher rates of tracheotomy and postoperative vocal fold paralysis. The small cohort did not reveal a significant association between surgery type and persistent disease. Interestingly, the data revealed a significant association between the use of incisional biopsy and persistent disease. Cases exhibiting extralaryngeal extension of the lesion were shown to exclusively belong to patients with neurofibromatosis/schwannomatosis syndromes.

Conclusions

Taken together, these findings suggest that incisional biopsy should be avoided, and given the benign nature of the pathology, the least invasive radical approach should be employed.

Laryngeal schwannoma: a systematic review

A large proportion of schwannomas are found in the head and neck region. Schwannoma located within the larynx however is uncommon. The characteristic features, clinical presentations, treatment and the outcomes of patients with laryngeal schwannoma are therefore not clearly understood. The aim of this comprehensive review is to compile, analyze and present the details to develop a consensus and augment the available literature on laryngeal schwannoma. A comprehensive literature search on laryngeal schwannoma was performed on PUBMED/MEDLINE, EMBASE, CINAHL and Science Citation Index using MeSH words. A total of 55 patients were reviewed in this study. 40.7 % of the tumours arose from the aryepiglottic fold or arytenoids. Other areas where tumours were found included the false cord, true vocal cord, epiglottis, subglottis, piriform sinus and the post cricoid area. 64.9 % patients presented with dysphonia. Others typically present with multiple symptoms related to the mass effect and location of the tumour. All patients were managed surgically with different techniques and approaches. Majority of patients were alive with no residual disease. There were five recurrences and no mortality to date. Schwannoma within the larynx can present with a variety of symptoms. Surgical excision remained as the treatment of choice with good overall prognosis.

Laryngeal schwannoma: excision via a laryngofissure approach

Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma.

Laryngeal schwannoma excised under direct laryngoscopy: case report

Laryngeal schwannomas (neurilemmomas) are extremely rare, and they present the otorhinolaryngologist with diagnostic and management challenges. These lesions usually present as a submucosal mass, and they are always a potential threat to the airway. We describe the case of a 75-year-old woman with a laryngeal schwannoma that arose from the left postcricoid area and covered the piriform sinus and arytenoid cartilage on that side. The tumor was completely excised under direct laryngoscopy with the use of a CO(2) laser, and preservation of the mucosal lining of the larynx was achieved.

Schwannoma of the larynx

Objectives

Neurogenic tumors of the larynx are extremely rare. The goal of this report is to advert to this rare disease, to review and discuss diagnostics, differential diagnoses and treatment options. Study Design: Retrospective case report and review of the literature. Methods: Case report of a schwannoma of the supraglottic larynx and review of the English- and German-language literature regarding neurogenic tumors of the larynx. Results: Neurogenic laryngeal tumors typically involve the supraglottic larynx, rarely the glottis. They can course globus sensation, dysphagia, dysphonia and upper airway obstruction. Imaging does not yield a definite diagnosis. The only curative treatment option is complete surgical resection. Conclusions: A definite diagnosis can only be made histologically. Endoscopic (laser-) resection for smaller lesions and external approaches for larger lesions are recommended treatment options.

Laryngeal schwannomas-case reports with rare presentations

Schwannomas also known as Neurilemmomas are benign encapsulated, slow growing perineural tumours of Neuro-ectodermal origin that arise from the sheet of schwann cells. Two cases are being presented due to their rarity and in both cases the diagnosis was arrived at after the excision of the tumour.