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Atypical sinonasal Schwannomas: a difficult diagnostic challenge
Galli Jacopo1, Imperiali Micaela, Cantore Italo
1Institute of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome, Italy.
Auris, Nasus, Larynx
|March 6, 2009
Summary
Diagnosing sinonasal Schwannomas is challenging. Nasal endoscopy aids diagnosis and surgical planning for these rare peripheral nerve sheath tumors, as demonstrated in two atypical cases.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pathology
Background:
- Schwannomas, benign peripheral nerve sheath tumors, are rare in the sinonasal tract (4%).
- Head and neck schwannomas typically occur in 25-45% of cases.
- Diagnostic and surgical challenges exist for sinonasal schwannomas.
Observation:
- Two atypical sinonasal schwannoma cases presented diagnostic difficulties.
- Initial misdiagnosis occurred in one case, suspecting angiofibroma based on imaging.
- Nasal endoscopy and biopsy were crucial for diagnosis in the second case.
Findings:
- Both cases involved cystic schwannomas.
- Histological examination confirmed diagnosis post-operatively in the first case.
- Complete endoscopic resection was performed, with craniotomy in one case, showing no recurrence at 9 months.
Implications:
- Nasal endoscopy is vital for accurate tumor assessment and biopsy in sinonasal schwannomas.
- Clinical presentation and imaging can be misleading, highlighting diagnostic challenges.
- Endoscopic approaches are effective for sinonasal schwannoma excision.
