Anterior Nasal Schwannoma: A Rare Sinonasal Neoplasm

Schwannomas are the most common type of benign peripheral nerve tumor in adults. Schwann cells assist in the conduction of nerve impulses and wrap around peripheral nerves to provide protection and support. Schwannomas typically arise from a single fascicle within the main nerve. Although they can occur anywhere in the body, nasal schwannomas are exceptionally rare. This case study presents a 65-year-old Caucasian female who had been experiencing obstructive nasal symptoms for three months. The in-office physical examination revealed a soft tissue expansile mass involving the submucosal tissues of the bilateral anterior nasal cavity, located just posterior to the columella. The mass was surgically excised in the operating room, and the diagnosis was confirmed through histopathology. With only 32 reported cases, nasal septal schwannomas are exceedingly rare. Diagnosis relies on histopathology for confirmation. However, their clinical presentation can mimic other sinonasal pathologies. A septal schwannoma should be considered as a differential diagnosis for a unilateral sinonasal mass. Complete excision is the definitive treatment and is associated with a low recurrence rate. The patient had no signs of reoccurrence on nasal endoscopy three months postoperatively. Surveillance MRI will be completed at one year.