1
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Liao JY, Lee HS, Kang BH. Nasal Cavity Schwannoma-A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2024; 103:19-24. [PMID: 34318692 DOI: 10.1177/01455613211034598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Schwannomas are rare slow-growing benign tumors arising from Schwann cells lining the nerve sheaths. Head and neck schwannomas account for about one-third of all cases, and only 4% of them arise from the sinonasal tract. Its diagnosis is based on histology and immunohistochemistry. Complete surgical excision is the most recommended treatment option, and endoscopic surgery has been widely performed in recent years. In this study, we presented a case of a 55-year-old female with schwannoma arising from the lateral wall of the nasal cavity, causing epistaxis and rhinorrhea. The patient underwent endoscopic excision with prompt resolution of symptoms. The reported cases of nasal cavity schwannoma were reviewed and summarized for educational purposes.
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Affiliation(s)
- Jyun-Yi Liao
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung
| | - Herng-Sheng Lee
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
| | - Bor-Hwang Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung
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2
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Venkatasamy R, Mohan Singh AS, Arasu K, Husain S, Mianxin C. Nasal Septal Ancient Schwannoma: Ancient and Rare. Cureus 2023; 15:e44294. [PMID: 37779818 PMCID: PMC10533952 DOI: 10.7759/cureus.44294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 10/03/2023] Open
Abstract
Schwannoma is a rare benign neurogenic tumor arising from the Schwann cells of peripheral nerves. A 77-year-old man presented with progressively worsening left nasal block and hyposmia for the past six months. Nasal endoscopy revealed a polypoidal reddish mass occupying the left middle meatus. The biopsy was in favor of ancient schwannoma. Endoscopic transnasal excision of the mass arising from the left nasal septum was performed. A middle meatal antrostomy was also performed. The tumor cells were positive for S100 protein. Presenting symptoms are common to other sinonasal tumors, and the differential diagnoses include carcinoma, inverted papilloma, sarcoma, lymphoma, and neurofibroma. Schwannomas are composed of spindle cells with two histologically distinct patterns that can be mixed: Antoni type A and Antoni type B. A neural crest marker antigen, S-100 protein, is useful to corroborate our diagnosis. It is vital to consider nasal septal schwannoma in the differential diagnosis of patients complaining of unilateral nasal obstruction with polypoidal nasal mass, especially the posterior third of the nasal septum. Transnasal endoscopic surgery is the preferred approach for nasal septal schwannoma.
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Affiliation(s)
- Rathakrishnan Venkatasamy
- Department of Otolaryngology - Head and Neck Surgery, National University of Malaysia, Kuala Lumpur, MYS
| | | | - Kanivannen Arasu
- Department of Otolaryngology - Head and Neck Surgery, Taiping Hospital, Taiping, MYS
| | - Salina Husain
- Department of Otolaryngology - Head and Neck Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, MYS
| | - Chew Mianxin
- Department of Pathology, Taiping Hospital, Taiping, MYS
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3
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Roy R, Patel B, Gahlot GPS. An Extensive Unilateral Nasal Mass: Septal Schwannoma-Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:1540-1543. [PMID: 36452653 PMCID: PMC9702375 DOI: 10.1007/s12070-021-02635-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022] Open
Abstract
Schwannomas are benign peripheral nerve sheath tumours that arise from the Schwann cells of the myelinated nerve and may occur throughout the body. Paranasal schwannomas are uncommon lesions, representing less than 4% of all head and neck schwannomas and nasal septal schwannomas are very rare. Here we report a rare case of sinonasal schwannoma in a 46-year-old male who presented with a history of progressive nasal blockage of 3 years duration. The mass was removed by endoscopic approach without any postoperative complication. The rarity of diagnosis was aided by immune histopathology (IHC) of the tissue to confirm the disease.
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Affiliation(s)
- Ravi Roy
- Department of ENT-HNS, Army Hospital Research and Referral, New Delhi, India
| | - Bhaumik Patel
- Department of ENT-HNS, Army Hospital Research and Referral, New Delhi, India
| | - Gaurav Pratap Singh Gahlot
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital Research and Referral, New Delhi, India
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4
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Maier H, Lorenz KJ, Woenkhaus C, Mühlmeier G. [Disfiguring neurinoma of the nose tip and the columella-rhinosurgical aspects]. HNO 2020; 68:787-790. [PMID: 31641799 DOI: 10.1007/s00106-019-00755-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Neurinomas in the nose and the nasal sinuses are rare. In the present work, we present an exceedingly rare case of a disfiguring neurinoma involving the nasal columella. Treatment of choice is complete resection of the tumor. For an optimal view for tumor resection and esthetic and functional reconstruction, we recommend an open surgical approach.
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Affiliation(s)
- H Maier
- HNO-Privatpraxis im Areion-Zentrum Neu-Ulm, Reuttier Str. 27, 89231, Neu-Ulm, Deutschland.
| | - K J Lorenz
- HNO-Privatpraxis im Areion-Zentrum Neu-Ulm, Reuttier Str. 27, 89231, Neu-Ulm, Deutschland.,Klinik für HNO-Heilkunde, Kopf- und Halschirurgie am Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
| | - C Woenkhaus
- Pathologische Gemeinschaftspraxis Dr. Fabian, PD Dr. Woenkhaus, Dr. Komposch Ulm, Ulm, Deutschland
| | - G Mühlmeier
- HNO-Privatpraxis im Areion-Zentrum Neu-Ulm, Reuttier Str. 27, 89231, Neu-Ulm, Deutschland.,Klinik für HNO-Heilkunde, Kopf- und Halschirurgie am Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
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5
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Differential Diagnosis Between Nasal Septal Schwannoma and Nasal Septal Neurofibroma. J Craniofac Surg 2018; 28:1780-1783. [PMID: 28834833 DOI: 10.1097/scs.0000000000003748] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Recently, as the authors experienced nasal septal schwannoma and nasal septal neurofibroma with similar clinical symptoms but different endoscopic findings, the authors tried to review all the literatures previously reported on the "Nasal septal schwannoma and Nasal septal neurofibroma." The aim of this study is to thoroughly review previously reported patients with nasal septal schwannomas and neurofibromas and to describe similar and different features focusing on the differential diagnosis between the 2 entities. On the basis of our review, the authors made some important conclusions. First, benign peripheral nerve tumors originating from the nasal septum are uncommon. Especially, nasal septal neurofibroma is extremely rare that only 5 patients were reported. So, more clinical reports of benign peripheral nerve tumors are necessary to elucidate the differences between nasal septal schwannoma and nasal septal neurofibroma. Second, there are some similar features between nasal septal schwannoma and nasal septal neurofibroma such as clinical symptoms, endoscopic findings, and treatment strategy. However, since there seem to be some differences in nasal endoscopic findings, they may be helpful for the provisional diagnosis, and so more patients should be reported to verify that point. Third, image study, especially magnetic resonance imaging (MRI), is considered to be a useful tool for differential diagnosis of benign peripheral nerve tumors originating from the nasal septum. So, more clinical reports reporting MRI findings are needed to verify the differences. Last, because of distinctive histologic appearances of benign peripheral nerve tumors, it is usually not difficult to make the distinction between nasal septal schwannoma and nasal septal neurofibroma. However, immunohistochemical stains including S-100 protein, calretinin, CD 34, factor XIIIa, and CD56 are necessary when it is difficult to differentiate between 2 disease entities.
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6
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Gupta M, Rao N, Kour C, Kaur I. Septal Schwannoma of the Nose: A Rare Case. Turk Arch Otorhinolaryngol 2017; 55:41-43. [PMID: 29392052 DOI: 10.5152/tao.2017.1929] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/03/2016] [Indexed: 11/22/2022] Open
Abstract
A schwannoma is a benign tumor arising from Schwann cells present in the nerve sheath of myelinated nerves.It is rarely seen in the nose and paranasal sinuses, and it very rarely originates from the nasal septum. A 40-year-old female presented to our outpatient department with a gradual onset, progressive, left nasal obstruction since the last 4 years. On performing a local examination, a soft tissue mass occupying the left nasal cavity was seen. Surgery via the external approach was performed; the mass was found to arise from the nasal septum and was totally excised. Histopathologic examination revealed a schwannoma. Nasal septal schwannoma along with review of the literature is a rare entity. It should be considered in the differential diagnosis of benign tumors of the nasal cavity.
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Affiliation(s)
- Manish Gupta
- Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India
| | - Naiya Rao
- Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India
| | - Chandpreet Kour
- Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India
| | - Ivreet Kaur
- Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India
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7
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Surapaneni B, Hanly E, Kadakia S, Moscatello A, Kamat A. Endoscopic resection of nasal schwanomma as a diagnostic and therapeutic adjunct in the treatment of a rare disorder: A case report with literature review. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2017. [DOI: 10.1080/23772484.2017.1281713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Bhavishya Surapaneni
- Department of Otolaryngology, University of Southern California, Los Angeles, CA, USA
| | - Elyse Hanly
- Department of Otolaryngology-Head and Neck Surgery, New York Medical College, Valhalla, NY, USA
| | - Sameep Kadakia
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Augustine Moscatello
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Ameet Kamat
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
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8
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Schwannoma Located in Nasopharyngeal Region. Case Rep Otolaryngol 2016; 2016:8260629. [PMID: 27293938 PMCID: PMC4886060 DOI: 10.1155/2016/8260629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 04/26/2016] [Indexed: 11/30/2022] Open
Abstract
Schwannoma is a tumor which has neuroectoderm origins, is hard, well-circumscribed, encapsulated, and slow growing benign cranial tumor, and may autonomously grow out of the nerve sheath of peripheral nerves. It is mostly seen in the head and neck region. In the paranasal sinus and nose areas, it is seen at a rate of 4%. The diagnosis is mostly made after histopathological examination. In this paper, a Schwannoma case observed in the nasopharyngeal region was presented in a 20-year-old female who had complaints of sleeping with open mouth, snoring, foreign body feeling in throat, and swallowing difficulties. The tumor was extracted via transoral approach. No recurrence was observed during follow-up over the next year. This case presentation is presented for the first time in the literature in English.
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9
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Kwak SG, Kim CD, Kim YJ, Kim SW. A Case of Recurrent and Multiple Schwannomas in the Caudal Septum. JOURNAL OF RHINOLOGY 2015. [DOI: 10.18787/jr.2015.22.1.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Seul Gi Kwak
- Department of Otolaryngology-Head and Neck Surgery, Veterans Health Service Medical Center, Seoul, Korea
| | - Choon Dong Kim
- Department of Otolaryngology-Head and Neck Surgery, Veterans Health Service Medical Center, Seoul, Korea
| | - Yoon Jung Kim
- Department of Pathology, Veterans Health Service Medical Center, Seoul, Korea
| | - Seung Woo Kim
- Department of Otolaryngology-Head and Neck Surgery, Veterans Health Service Medical Center, Seoul, Korea
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10
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Azani AB, Bishop JA, Thompson LDR. Sinonasal Tract Neurofibroma: A Clinicopathologic Series of 12 Cases with a Review of the Literature. Head Neck Pathol 2014; 9:323-33. [PMID: 25503638 PMCID: PMC4542792 DOI: 10.1007/s12105-014-0593-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/15/2014] [Indexed: 01/13/2023]
Abstract
Neurofibroma (NF), a benign peripheral nerve sheath tumor, is very uncommon in the sinonasal tract, with only a few reported cases in the English literature. Cases within the files of the authors' institutions confined to the sinonasal tract were compared to cases reported in the English literature (Medline 1966-2014). The 12 patients included 6 females and 6 males, aged 26-75 years (mean 46.2 years). The patients usually presented clinically with a mass lesion (n = 11), obstruction (n = 4) or pain (n = 3), with an average symptom duration of 42.9 months. Two patients had neurofibromatosis (NF1). Tumors involved the nasal cavity alone (n = 8), maxillary sinus alone (n = 2), or mixed sites (n = 2), with a range of 0.4-4.1 cm (mean 2.2 cm). The tumors were circumscribed, composed of spindled to wavy cells with curvilinear nuclei set in a background of collagenized stroma and mast cells. Nuclear palisading and perivascular hyalinization were not seen. Mitoses were scant. Pleomorphism, necrosis and increased cellularity were absent. By immunohistochemistry, the lesional cells were S100 protein, SOX10 and NFP positive, while CD34 highlighted the perineurium. INI1 was intact, with strong nuclear expression in all cases. All patients had surgical excision without recurrence (mean follow-up 8.6 years). The principle differential diagnoses include schwannoma, perineurioma, fibromatosis, and solitary fibrous tumor. NF of the sinonasal tract occurs in middle-aged patients without a gender predilection, usually with non-specific symptoms present for a long duration. Tumors are relatively large (mean 2.2), and usually affect one site only. Surgery is curative, with only 16.7 % NF1 associated. S100 protein, SOX10 and NFP highlight the Schwann cells, with CD34 highlighting the perineural fibroblasts.
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Affiliation(s)
- Ari B. Azani
- />Department of Pathology, Southern California Permanente Kaiser Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Justin A. Bishop
- />Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Lester D. R. Thompson
- />Department of Pathology, Southern California Permanente Kaiser Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
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11
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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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12
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Xu J, Zheng Y, Li G, Su X. A rare finding of multiple schwannomas in the epiglottis. Otolaryngol Head Neck Surg 2012; 147:1160-1. [PMID: 22675001 DOI: 10.1177/0194599812450687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jianle Xu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
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13
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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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14
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Pagella F, Giourgos G, Matti E, Colombo A. An Asymptomatic Schwannoma of the Nasal Septum: Report of a Unique Case. EAR, NOSE & THROAT JOURNAL 2009. [DOI: 10.1177/014556130908801210] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Schwannomas of the nasal septum are extremely rare, and therefore their diagnosis and treatment can pose certain challenges. We describe the case of an incidentally discovered schwannoma of the nasal septum that was unique in that the lesion was completely asymptomatic. In view of our finding, we believe that routine examinations of both nasal fossae should be considered during routine diagnostic laryngeal flexible endoscopy.
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Affiliation(s)
- Fabio Pagella
- From the Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo and the University of Pavia, Pavia, Italy
| | - Georgios Giourgos
- From the Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo and the University of Pavia, Pavia, Italy
| | - Elina Matti
- From the Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo and the University of Pavia, Pavia, Italy
| | - Andrea Colombo
- From the Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo and the University of Pavia, Pavia, Italy
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15
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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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16
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Park EH, Lee SS, Byun SW. A schwannoma in the nasal septum. Eur Arch Otorhinolaryngol 2007; 265:983-5. [PMID: 18038144 DOI: 10.1007/s00405-007-0541-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Accepted: 11/09/2007] [Indexed: 11/28/2022]
Abstract
Schwannomas of the sinonasal tract are very rare neoplasms. We present the case of a schwannoma developing in the nasal septum. The patient was a 51-year-old woman with the complaint of unilateral nasal obstruction. We completely removed this tumor by an endoscopic approach. We discuss the clinical presentation, differential diagnosis, and treatment of this rarely encountered neoplasm.
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Affiliation(s)
- Eun Hee Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, 911-1 Mok-Dong, Yang Cheon-Ku, Seoul 158-710, South Korea
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17
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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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18
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Abstract
Schwannomas of the nasal cavity and paranasal sinuses are very rare. We report the case of a 54-year-old woman with a schwannoma arising from the nasal septum. We discuss the clinical presentation, differential diagnosis, imaging characteristics and treatment of this rarely encountered lesion.
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Affiliation(s)
- S Rajagopal
- Department of Otolaryngology, Head & Neck Surgery, Fairfield General Hospital, Bury, Lancashire BL9 7TA, UK
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19
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O'Brien DF, Farrell M, Pidgeon CN. Combined nasal and skull base pathology: adjacent nasal schwannoma and olfactory groove meningioma. Br J Neurosurg 2006; 19:446-8. [PMID: 16455571 DOI: 10.1080/02688690500390433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A 55-year-old woman presented with a longstanding history of headache and personality change. Preoperative imaging suggested an olfactory groove meningioma invading the posterior nasal space. Following surgical removal of the lesion histopathology confirmed the presence of both a nasal schwannoma and an olfactory groove meningioma. This dual pathology may represent a variation of neurofibromatosis type 2 (NF-2).
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Affiliation(s)
- D F O'Brien
- Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland.
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21
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Abstract
Schwannomas of the nasal cavity are extremely rare. We evaluated a 42-year-old woman who presented with a 4-year history of slowly progressive nasal obstruction. The cause of the obstruction was identified as a schwannoma in the left inferior turbinate. The tumor was completely excised, and no sign of recurrence was evident at the 1-year follow-up. To the best of our knowledge, this is only the third case of a schwannoma originating in the inferior nasal turbinate that has been reported in the English-language literature. We review the clinical and pathologic features of this case.
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22
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Shinohara K, Hashimoto K, Yamashita M, Omori K. Schwannoma of the nasal septum removed with endoscopic surgery. Otolaryngol Head Neck Surg 2005; 132:963-4. [PMID: 15944574 DOI: 10.1016/j.otohns.2004.09.065] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A 50-year-old woman presented with a 30-year history of nasal obstruction. She had been treated for paranasal sinusitis at other hospitals and she was referred to our hospital for further examination. Flexible endoscopy revealed a mass in the posterior aspect of the right nasal cavity to the posterior aspect of the left nasal cavity around the posterior edge of the nasal septum.
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Affiliation(s)
- Kaoru Shinohara
- Department of Otolaryngology, Nishi-Kobe Medical Center, Kobe, Japan
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23
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Facon F, Forman C, Paris J, Chapon F, Moulin G, Dessi P. [A case of nasal septum schwannoma: endoscopic resection]. ACTA ACUST UNITED AC 2004; 121:179-83. [PMID: 15224005 DOI: 10.1016/s0003-438x(04)95507-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To define clinical and radiological characteristics of nasal septal schwannoma, and to propose endoscopic surgery. PATIENT AND METHODS We report a case of an isolated schwannoma of the anterior part of the nasal septum, without involvement of any local structure. The only preoperative symptom was nasal obstruction. Imaging study included a CT scan and an MRI study. RESULTS Schwannoma is a sheath tumor originating from Schwann cells of peripheral nerves. It rarely occurs in nasal and paranasal sinuses and its development on the nasal septum is extremely rare. Complete removal of the tumor was performed by endoscopic sinus surgery technique. Limits of the excision were free of tumor and the histological type was Antoni type A Schwannoma. After a year of follow up, the patient is free of recurrence. CONCLUSION The Schwannoma of the nasal septum is a rare tumour whose clinical and radiological diagnosis by CT scan and IRM is relatively easy. Its treatment is surgical and the endoscopic surgery can be proposed in the forms slightly extensive.
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Affiliation(s)
- F Facon
- Fédération d'Oto-rhino-laryngologie et de chirurgie de la face et du cou.
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24
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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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Wada A, Matsuda H, Matsuoka K, Kawano T, Furukawa S, Tsukuda M. A case of schwannoma on the nasal septum. Auris Nasus Larynx 2001; 28:173-5. [PMID: 11240326 DOI: 10.1016/s0385-8146(00)00099-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case of nasal septal schwannoma. The patient was a 62-year-old female complaining of bilateral nasal obstruction. Anterior rhinoscopy revealed a smooth-surfaced mass arising from the nasal septum in both nasal cavities. Computed tomography scan showed a mass with enhancement in the two nasal cavities and the ethmoid sinuses, and this mass extended to the skull base. Lateral rhinotomy was performed under general anesthesia. The tumor arose from the nasal septum, occupied both nasal cavities, and extended to the anterior ethmoid sinuses. It was encapsulated and could be totally removed en bloc. Pathological examination of the excised specimen showed that it was an Antoni type A schwannoma. The tumor cells were immunoreactive for S-100 protein. The patient is doing well with no evidence of recurrence.
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Affiliation(s)
- A Wada
- Department of Otorhinolaryngology, Urafune Hospital, Yokohama City University School of Medicine, 3-46 Urafune-cho, Minami-ku, 232-0024, Yokohama, Japan
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27
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Abstract
We present a case of neurofibroma of the nasal inferior turbinate operated under endoscopic control. A 29 year-old female reported progressive left-side nasal obstruction over the past year. Endoscopic examination revealed a mass arising from the left inferior turbinate. Evaluation of multiple sections of the mass by hematoxylin and eosin, S-100 protein and neuron specific enolasa stains showed the tumor to be a neurofibroma.
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Affiliation(s)
- P M Moreno
- Servei d'ORL, Hospital Santa Maria, Lleida-Catalunya, Spain
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28
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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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Oi H, Watanabe Y, Shojaku H, Mizukoshi K. Nasal septal neurinoma. ACTA OTO-LARYNGOLOGICA. SUPPLEMENTUM 1993; 504:151-4. [PMID: 8470524 DOI: 10.3109/00016489309128144] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A case of nasal septal neurinoma is presented. The patient was a 71-year-old male who complained of nasal obstruction and epistaxis. Results of the physical examination showed a giant mass filling the nasal cavity and the nasopharynx. A biopsy taken from its tissue surface showed histological features of neurofibroma. The lesion was completely resected with the patient under general anesthesia. The tumor completely occupied the right nasal cavity and the nasopharynx, partially penetrated the nasal septum and extended to the left nasal cavity. After the operation, the final pathological diagnosis was not neurofibroma but neurinoma in which Antoni type A and type B cells were mixed. The postoperative course was uneventful, and no recurrence has been observed to date.
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Affiliation(s)
- H Oi
- Department of Otolaryngology, Toyama Medical and Pharmaceutical University, Japan
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Bavetta S, McFall MR, Afshar F, Hutchinson I. Schwannoma of the anterior cranial fossa and paranasal sinuses. Br J Neurosurg 1993; 7:697-700. [PMID: 8161435 DOI: 10.3109/02688699308995102] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Only two cases of schwannomas involving the anterior cranial fossa and paranasal sinuses or nasal fossa have been reported previously. We describe a third case which involved all of these structures and also the left orbit.
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Affiliation(s)
- S Bavetta
- Department of Neurosurgery, Saint Bartholomew's Hospital, London, UK
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31
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Abstract
We report a rare case of nasal neurinoma. The patient was a 21-year-old man, who complained of nasal obstruction. The tumor was successfully excised, and was found to be a benign Schwannoma (neurinoma). The patient had an uneventful course with no signs of recurrence. Reports in the world literatures of neurinomas in the nasal cavity and the paranasal sinuses are reviewed.
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Affiliation(s)
- R Higo
- Department of Otolaryngology, Kameda General Hospital, Kamogawa, Japan
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