Abstract
Schwannomas are benign tumors arising from Schwann cells of myelinated nerve sheath. Schwannomas of the nasal cavity and paranasal sinuses are rare, with only 4% occurrence. We report a case of a 48-year-old lady who presented with 1-year history of progressively worsening left nasal blockage. Rigid nasoendoscopy showed a smooth, globular mass occupying the left nasal cavity. The mass arose from the left nasal septum and impinged on the anterior part of the middle turbinate posteriorly and inferior turbinate anteriorly. Computed tomography of the paranasal sinuses showed a 3.8 × 1.8 x 3.7- cm enhancing soft tissue density in the left nostril. The mass obliterated the left nasal cavity and caused deviation of the septum to the right. The patient underwent an endoscopic excision and histopathologic examination confirmed the diagnosis of Schwannoma. Postoperative recovery was uneventful and no recurrence was seen in the follow-up period.
 Bangladesh Journal of Medical Science Vol.18(3) 2019 p.660-662
Highlights
Whereas only about 4% occurrence in the nasal cavity and paranasal sinuses has been reported,[1,2,3] and the nasal septum Schwannomas is even rarer, with only few cases previously reported in the literature.[2,5]
Rigid nasoendoscopy showed globular left nasal mass arising from left nasal septum and extending down to the floor of left nasal cavity [Figure 1]
Patient was subjected for contrast enhanced computed tomography (CECT) of the paranasal sinuses to see the mass extension which showed a well-defined polypoidal shape enhancing soft tissue density in the anterior part of the left nasal
Summary
Schwannoma or neurilemomas are neurogenic benign lesions, originating from myelinated Schwann cells of the peripheral nerve sheath.[1,2,3,4] Approximately 25-45% Schwannomas occurred in head and neck region[1,2,5] with the most common nerve affected is the cranial nerve VIII presenting as vestibular Schwannoma (formerly known as acoustic neuromas).[2,3] Whereas only about 4% occurrence in the nasal cavity and paranasal sinuses has been reported,[1,2,3] and the nasal septum Schwannomas is even rarer, with only few cases previously reported in the literature.[2,5] The first case of nasal septal Schwannoma was first described by Bogdasian and Stoutin 19435. Case report A 48 years old lady with underlying hypertension, presented with progressive left nasal blockage for one year duration associated with occasional bloodstained, foul smelling nasal discharge and headache. She has no background history of allergic rhinitis. Rigid nasoendoscopy showed globular left nasal mass arising from left nasal septum and extending down to the floor of left nasal cavity [Figure 1]. Endoscopic excision of nasal septal schwannoma:case report and review of literature cavity and left middle meatus measuring 3.7cmX 1.8cm X 3.7cm [Figure 2]. The mass cause deviation of the nasal septum to the right It does not erode any of the mucosa, cartilage or bone and does not extend beyond the nasal cavity. Eight months post surgery and patient is symptom free with no recurrence
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