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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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Aref H, Abizeid GA. Axillary schwannoma, preoperative diagnosis on a tru-cut biopsy: Case report and literature review. Int J Surg Case Rep 2018; 52:49-53. [PMID: 30316135 PMCID: PMC6187017 DOI: 10.1016/j.ijscr.2018.09.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 12/26/2022] Open
Abstract
Although Axillary Schwannoma is a rare condition, physicians should recognize it as a part of their differential diagnosis of an axillary swelling. Preoperative utilization of Tru-cut biopsy in diagnosing this condition will further help surgeons to plan proper surgical treatment. The author recommends utilizing an intraoperative nerve stimulator to facilitate nerve preservation during excision; aiming to provide optimal management and better outcome.
Introduction Schwannoma is a benign encapsulated tumor of the peripheral nervous system which is mainly located in the head and neck. However, axillary Schwannoma is rare. In this article, the author presents an interesting case of a right axillary Schwannoma, where the diagnosis was preoperatively made on a Tru-cut biopsy. Case presentation We report a case of an enlarged right axillary swelling in a sixty-year-old male. Proper radiologic workup was performed. Furthermore, a Tru-cut biopsy was taken which revealed evidence of schwannoma. Having such symptomatic lesion, operative excision was done with the use of a nerve stimulator, which aided in preserving nerve function. Conclusion With such non-specific presentation, axillary Schwannoma may be easily missed and mismanaged. A Tru-cut biopsy may provide great help in expert hands, aiding operative planning; likewise in the case we are presenting. Furthermore, utilizing an intraoperative nerve stimulator will facilitate nerve preservation.
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Affiliation(s)
- Hager Aref
- Department of Surgery, International Medical Center, P.O. Box 1716, Jeddah 21441, Saudi Arabia.
| | - Georges A Abizeid
- Department of Surgery, International Medical Center, P.O. Box 1716, Jeddah 21441, Saudi Arabia.
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3
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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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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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5
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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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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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7
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Braunschweig F, Kramer MF, Assmann G, Arbogast S, Leunig A. [Schwannoma of the nasal cavity: a case report]. HNO 2008; 55:1013-6. [PMID: 17874054 DOI: 10.1007/s00106-007-1612-y] [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: 11/26/2022]
Abstract
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.
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Affiliation(s)
- F Braunschweig
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Ludwig-Maximilians-Universität, München.
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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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9
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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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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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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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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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