Introduction

Schwanommas are benign tumors originating from the nerve sheath that occur solitarily or as part of Neurofibromatosis type 2. By far the most common manifestation in the head and neck region is the vestibular schwannoma. Theoretically, schwannomas can arise from any cranial or peripheral nerves but manifestations in the head and neck region other than vestibular are rare. Here we describe a case of a sinunasal schwanomma.

Case presentation

A 56-year-old female patient presented in our outpatient clinic with a history of left-sided nasal obstruction for four months. Examination of the nose showed an endonasal spherical, soft mass with a diameter of approx. 1 cm originating from the left nasal ala. No signs of infiltration of the septum or other surrounding structures, no bleeding or ulceration was seen.The MRI showed signs of a benign tumor. For further diagnosis, a sample was taken under local anesthesia and the histopathology resulted in the diagnosis of a sinunasal schwannoma. The tumor was resected under anesthesia and the defect was covered with a full-thickness skin transplant from the neck in a second operation.

Discussion

The sinunasal region accounts for only 4% of all schwannomas. Consequently, a general therapeutic guideline has not yet been published. Especially with vestibular schwannomas, a wait-and-scan approach is possible. Whether or not treatment of schwannomas in other locations is necessary depends on growth and symptoms and can be done by excision or stereotactic radiation. In our case the quality of life was reduced due to nasal obstruction and excision of the tumor and defect coverage could be safely performed.

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