Schwannoma of the nasal septum

Nasal Cavity Schwannoma-A Case Report and Review of the Literature

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.

Nasal Septal Ancient Schwannoma: Ancient and Rare

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.

A Case of Schwannoma in Subfrontal Area and Nasal Cavity

Schwannoma is a benign solitary neoplasm emerging from the Schwann cells of the peripheral, cranial and autonomic nerves. Approximately 25 to 45% of schwannomas occur in the head and neck region. However, schwannoma in the subfrontal area, nasal cavity or paranasal sinus is very rare and accounts for only 4% of these neoplasms. We experienced a case of schwannoma in the subfrontal area and left nasal cavity in a 74-year-old man who complained of recurrent rhinorrhea. We report this unusual case of schwannoma with a review of the literature.

A rare case of nasal septal schwannoma: Case report and literature review

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Schwannoma is a benign nerve sheath tumor that can arise from any myelinated nerve fiber.

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Nasal septal schwannoma is rare, and only 32 cases have been reported in the literature.

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The diagnosis of the nasal septal schwannoma primarily depends on histopathological examination.

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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.

Differential Diagnosis Between Nasal Septal Schwannoma and Nasal Septal Neurofibroma

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.

Nasal septal schwannoma: a rare sinonasal tumour with certain peculiarities

Sinonasal schwannomas constitute 4% of head and neck nerve sheath tumours; however, schwannomas involving the nasal septum are quite rare. We present a 57-year-old male patient with nasal septal schwannoma who was managed successfully by endoscopic excision. 32 cases of septal schwannoma have been reported so far in the literature. This report discusses certain peculiar features exhibited by schwannomas of the nasal septum. Septal schwannoma does not show any age, sex or side predilection. However, they tend to involve posterior part of the septum and presumed to arise from the nasopalatine branch of the trigeminal nerve. Imaging findings of the sinonasal schwannoma are non-specific, but the histopathological characteristics are diagnostic, with seldom need for immunohistochemistry. Endoscopic excision is the safe and effective treatment option for the septal schwannoma of any size and location. Recurrence has not been reported in the literature following endoscopic excision.

Nasal Septal Schwannoma: Advances in Diagnosis and Treatment

The nasal septum is one of the rarest sites of origin of schwannomas. Recently, as the authors experienced a patient with nasal septal schwannoma completely removed by transnasal endoscopic approach, the authors tried to review all the literatures reported since Berlucchi's report in 2000. To the best of our knowledge, only 18 patients with nasal septal schwannoma in the literatures written by English-language have been reported. The purpose of this study is to describe our recent experience and thoroughly review our collected patients with nasal septal schwannoma with particular emphasis on therapeutic options. Additionally, it is to describe the changes in clinical symptoms, diagnosis, and treatment of nasal septal schwannoma by comparing our data with Berlucchi's data. Based on our review, the authors suggest some conclusions. First, since common symptoms were nonspecific like other intranasal tumors, the authors should keep in mind that nasal septal schwannoma is included in the differential diagnosis of unilateral nasal mass pathologies with a high degree of suspicion on the basis of the endoscopic findings. Second, although there is no diagnostic computed tomography (CT) finding of nasal septal schwannoma, CT scan with contrast enhancement is helpful in defining the origin and location of the tumor and the involvement of vital structures. Third, combined immunohistochemical staining for S-100 protein, calretinin, and CD56 in addition to the light microscopic findings can be very useful as a simple, easy, and reliable method for definite diagnosis. Last, transnasal endoscopic surgery is the most suitable approach for treating any size and location of nasal septal schwannomas.

A solitary malignant schwannoma in the choana and nasal septum

Malignant schwannoma is an extremely rare tumor and the risk of malignant schwannoma increases in patients with von Recklinghausen's disease. Recently, we encountered a case of solitary malignant schwannoma in the choana and posterior nasal septum. Malignant schwannoma has not been previously reported in these locations. A 53-year-old man, who was immunologically healthy and showed no abnormal dermatological lesions, presented with a polypoid mass in the right nasal cavity and underwent endoscopic mass excision. The mass originated from the choana and the posterior portion of the right nasal septum. This mass was confirmed as a malignant schwannoma on histological examination and immunohistochemical staining. After endoscopic excision, postoperative adjuvant radiotherapy was administered, and there was no recurrence at 1 year after treatment. This case suggests that a solitary malignant schwannoma should be considered in the differential diagnosis of a mass in the posterior nasal cavity.

A surprising cause of unilateral nasal obstruction and epistaxis: nasal septal schwannoma

Schwannomas of the head and neck are the most common form of benign nerve sheath tumours, most commonly arising in the form of vestibular schwannomas. Schwannoma of the nasal cavity is an uncommon presentation of this pathology and specifically Schwannoma of the nasal septum is a rare presentation of this well understood disease process. We present the case of a 31-year-old Eastern European male who presented with unilateral nasal obstruction, congestion and epistaxis of 3 months duration. After imaging and biopsy, the diagnosis of nasal septal schwannoma was made on histological examination. This diagnosis of a unilateral nasal mass in a young man provides an opportunity to discuss the varied presentations of schwannoma as well as to examine to possible causes of nasal and septal masses in this demographic.

Computed tomography and pathological findings of five nasal neurilemmomas

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.

An Asymptomatic Schwannoma of the Nasal Septum: Report of a Unique Case

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.

[Schwannoma of the nasal cavity: a case report]

Schwannomas of the nasal cavity and paranasal sinuses are quite rare, with 4% occurring in this location. Most of them are benign and do not recur when totally removed by surgery. It is very important to distinguish between schwannoma and primary benign neurofibroma. Neurofibromas are lesions having the possibility for malignant transformation and recurrence. A case of schwannoma in the nasal cavity is reported, and the diagnostic and therapeutic procedures, as well as recommendations from the literature, are described. The histological and immunohistochemical features are discussed in detail to draw a distinction between schwannoma and neurofibroma. In cases of intranasal and paranasal lesions, the existence of a schwannoma must be considered. Differentiating between schwannoma and neurofibroma is important for estimating the risk of malignant transformation and recurrence.

A schwannoma in the nasal septum

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.

Schwannoma of the Nasal Cavity

Schwannomas are benign peripheral nerve sheath tumors that occur throughout the body. They may present as either solitary or multiple masses. They rarely occur in the nasal cavity. The diagnosis is often made only after histologic examination. Because these lesions are radioresistant, the preferred treatment is complete surgical excision. We present a new case of a schwannoma of the nasal cavity.