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Malignant sinonasal epithelioid schwannoma
P L Fernández1, A Cardesa, J A Bombí
1Department of Anatomical Pathology, Hospital Clínic, University of Barcelona Medical School, Spain.
Virchows Archiv. A, Pathological Anatomy and Histopathology
|January 1, 1993
Summary
This study presents a rare epithelioid malignant schwannoma in the head and neck, specifically the paranasal sinuses. Diagnosis required distinguishing it from melanoma and other tumors, with poor prognosis despite treatment.
Area of Science:
- Oncology
- Pathology
- Head and Neck Surgery
Background:
- Malignant schwannomas are rare, particularly in the head and neck region.
- Epithelioid subtype is exceptionally uncommon in the paranasal sinuses.
Observation:
- A case of epithelioid malignant schwannoma involving the maxillary sinus, nasal cavity, and orbit in a 27-year-old male.
- Symptoms included headache, nasal obstruction, and epistaxis.
- Tumor exhibited a biphasic pattern with spindle and epithelioid elements.
Findings:
- Histological and immunohistochemical analysis (S-100, GFAP, vimentin positive; HMB-45, cytokeratins negative) confirmed the diagnosis.
- Electron microscopy revealed mesaxon formation.
- Differential diagnosis included malignant melanoma, squamous cell carcinoma, and olfactory neuroblastoma.
Implications:
- Highlights the rarity and diagnostic challenges of epithelioid malignant schwannoma in the sinonasal tract.
- Underscores the aggressive nature of this tumor, with a poor prognosis despite multimodal treatment.
- Emphasizes the need for accurate diagnosis and consideration of this rare entity in sinonasal neoplasms.