AN UNUSUAL CASE OF NASAL SEPTAL SCHWANNOMA : A CASE REPORT

DR. HETAL MARFATIA; DR. NILAM U. SATHE; DR.SUBODH HOSAGADDE; DR.ANKUR PARIKH

Volume : V, Issue : VI, June - 2016

AN UNUSUAL CASE OF NASAL SEPTAL SCHWANNOMA : A CASE REPORT

Dr. Hetal Marfatia, Dr. Nilam U. Sathe, Dr. Subodh Hosagadde, Dr. Ankur Parikh

Abstract :

 ABSTRACT Introduction: 25–45% of Schwannomas arise in the head and neck region, only 4% of them present in the nose and paranasal sinus. Generally it involves the ethmoidal and maxillary sinuses. It may arise from the anches of trigeminal nerve (ophthalmic or maxillary) or from autonomic nervous system. The diagnosis by imaging is difficult due to lack of characteristic features. A variety of sino–nasal tumours share similar imaging features; hence istopathological diagnosis is a gold standard. Case report: A 38 year old female presented with bilateral nasal blockage (Left >Right) since 2 years which gradually progressed to cause complete blockage. It was associated with mucoid nasal discharge and hyposmia. There was a single episode of epistaxis. Anterior rhinoscopy showed left nasal polyp. CT scan and MRI of the paranasal sinuses was performed. MRI of the paranasal sinuses showed a heterogenous mass lesion which is hypointense on T1WI and hyperintense on T2WI with patchy central necrotic areas and hemorrhages, intensely enhancing on contrast. Endoscopic approach helped to prevent unwanted removal of healthy nasal mucosa and the anterior and superior septum which helped to maintain the shape of the nasal dorsum. Histopathological analysis of the tumour showed spindle cells arranged in Antony A and Antony B pattern. Conclusion: Sino–nasal schwannoma is a well–defined soft tissue mass with pressure remodelling of surrounding structures clinical or radiological diagnosis is not conclusive and hence histopathology is the gold standard for diagnosis. Complete surgical excision can be achieved by endoscopic approach successfully