Log in

Endoscopic Management of Ethmoidal Schwannoma: A Case Report

  • Clinical Report
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Schwannomas of sinonasal origin are rare tumours with an incidence as low as 4% and may present with a wide range of clinical features. Due to non-specific endoscopic and radiological findings, diagnosis becomes difficult. We present a case of an ethmoidal schwannoma with nasal and nasopharyngeal extension in an elderly female patient who had a slow course of the long-standing disease. Her main complaints were nasal obstruction, nasal discharge, mouth breathing, snoring and recurrent nasal bleed. Nasal endoscopy showed a pale, firm, polypoidal mass with dilated vessels on the surface which bled on probing. It was a non-enhancing sinonasal mass with scallo** of adjacent paranasal sinuses and erosion of posterior nasal septum on contrast-enhanced computed tomography. Endoscopic excision of the mass was done in toto and histopathology report confirmed it as schwannoma. Long standing sinonasal masses especially in the elderly age group with an indolent medical history should arise suspicion of benign neoplasm especially schwannomas due to their high rate of incidence amongst benign sinonasal neoplasms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kumar S, Sayoo C (2017) Sinonasal schwannoma: a rare sinonasal neoplasm. Indian J Otolaryngol Head Neck Surg. 69(3):425–427. https://doi.org/10.1007/s12070-017-1125-2

    Article  PubMed  PubMed Central  Google Scholar 

  2. Suh JD, Ramakrishnan VR, Zhang PJ, Wu AW, Wang MB, Palmer JN, Chiu AG (2011) Diagnosis and endoscopic management of sinonasal schwannomas. ORL J Otorhinolaryngol Relat Spec 73(6):308–312. https://doi.org/10.1159/000331923 (Epub 2011 Oct 5 PMID: 21986025)

    Article  PubMed  Google Scholar 

  3. Yang B, Wang Y, Wang S, Dong J (2015) Magnetic resonance imaging features of schwannoma of the sinonasal tract. J Comput Assist Tomogr 39(6):860–865. https://doi.org/10.1097/RCT.0000000000000308 (PMID: 26359585)

    Article  PubMed  Google Scholar 

  4. Ajiya A, Bello-Muhammad N (2019) Encapsulated sinonasal schwannoma mimicking an antrochoanal polyp. Niger Med J 60(6):326–329. https://doi.org/10.4103/nmj.NMJ_104_19

    Article  PubMed  Google Scholar 

  5. Sunaryo PL, Svider PF, Husain Q, Choudhry OJ, Eloy JA, Liu JK (2014) Schwannomas of the sinonasal tract and anterior skull base: a systematic review of 94 cases. Am J Rhinol Allergy 28(1):39–49. https://doi.org/10.2500/ajra.2014.28.3978 (PMID: 24717879)

    Article  PubMed  Google Scholar 

  6. Nelson E, Rennels M (1970) Innervation of intracranial arteries. Brain 93(3):475–490. https://doi.org/10.1093/brain/93.3.475 (PMID: 4097005)

    Article  CAS  PubMed  Google Scholar 

  7. Li YP, Jiang S, Zhou PZ, Ni YB (2012) Solitary olfactory schwannoma without olfactory dysfunction: a new case report and literature review. Neurol Sci. 33(1):137–42. https://doi.org/10.1007/s10072-011-0573-9. Epub 2011 Apr 12. Erratum in: Neurol Sci. 2012 Feb;33(1):217. PMID: 21484358

  8. Adachi K, Yoshida K, Miwa T, Ikeda E, Kawase T (2007) Olfactory schwannoma. Acta Neurochir (Wien) 149(6):605–610. https://doi.org/10.1007/s00701-007-1158-5

    Article  CAS  PubMed  Google Scholar 

  9. Klossek JM, Ferrie JC, Goujon JM, Fontanel JP (1994) Endoscopic approach of the pterygopalatine fossa: report of one case. Rhinology 32(4):208–210 (PMID: 7701230)

    CAS  PubMed  Google Scholar 

  10. Pasquini E, Sciarretta V, Farneti G, Ippolito A, Mazzatenta D, Frank G (2002) Endoscopic endonasal approach for the treatment of benign schwannoma of the sinonasal tract and pterygopalatine fossa. Am J Rhinol 16(2):113–118

    Article  PubMed  Google Scholar 

  11. Ulu EM, Cakmak O, Dönmez FY, Büyüklü F, Cevik B, Akdoğan V, Coşkun M (2010) Sinonasal schwannoma of the middle turbinate. Diagn Interv Radiol 16(2):129–131. https://doi.org/10.4261/1305-3825.DIR.1710-08.1 (Epub 2009 Oct 9 PMID: 19821257)

    Article  PubMed  Google Scholar 

  12. Liu HL, Yu SY, Li GK, Wei WI (2011) Extracranial head and neck Schwannomas: a study of the nerve of origin. Eur Arch Otorhinolaryngol 268(9):1343–1347. https://doi.org/10.1007/s00405-011-1491-4

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mey KH, Buchwald C, Daugaard S, Prause JU (2006) Sinonasal schwannoma–a clinicopathological analysis of five rare cases. Rhinology 44(1):46–52 (PMID: 16550950)

    CAS  PubMed  Google Scholar 

  14. Kanaan HA, Gardner PA, Yeaney G, Prevedello DM, Monaco EA 3rd, Murdoch G, Pollack IF, Kassam AB (2008) Expanded endoscopic endonasal resection of an olfactory schwannoma. J Neurosurg Pediatr 2(4):261–265. https://doi.org/10.3171/PED.2008.2.10.261 (PMID: 18831660)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arjun Suresh.

Ethics declarations

Conflicts of interest

There are no conflicts of interest.

Informed Consent

The authors certify that they have obtained appropriate patient consent forms. In the forms, patient has given her consent and other clinical information to be reported in the journal. The patient understands that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rathnakara, S.H., Suresh, A. & Subramaniam, V. Endoscopic Management of Ethmoidal Schwannoma: A Case Report. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 723–726 (2023). https://doi.org/10.1007/s12070-022-03238-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-022-03238-3

Keywords

Navigation