Objectives: Sinonasal schwannomas account for less than 4% of head and neck schwannomas, with the primary treatment modality being surgical excision via external approaches. The aim of this report is to present a rare...Objectives: Sinonasal schwannomas account for less than 4% of head and neck schwannomas, with the primary treatment modality being surgical excision via external approaches. The aim of this report is to present a rare case of recurrent schwannoma of the ethmoid cavity involving the anterior skull base which was successfully managed with endoscopic resection. Study Design: Case report and review of the literature. Methods: The clinical presentation, radiographic features, histopathologic characteristics, surgical approach, and patient outcome were examined in the context of a literature review. Results: A 43-year-old woman presented with a 9-month history of left facial pain and pressure. She had a prior history of sinonasal schwannoma excision with cerebrospinal fluid (CSF) leak repair via bifrontal craniotomy in 2007. Magnetic resonance imaging (MRI) and nasal endoscopy revealed a left ethmoid mass measuring 2.2 cm × 2.7 cm × 2.4 cm abutting the anterior skull base. The tumor was completely removed using a transnasal endoscopic approach, and the anterior skull base reconstructed with tensor fascia lata graft. Histology of the specimen showed schwannoma, and there has been no evidence of tumor recurrence nor CSF leak after 24 months of follow-up. Conclusion: With continual advances in surgical technique and instrumentation, sinonasal schwannomas have become increasingly more amenable to endoscopic resection even in the case of recurrence and skull base involvement.展开更多
Objective Intracranial schwannomas are frequently located in the VIII cranial nerve, followed by the V and VII cranial nerves, but are quite rare in the olfactory cranial nerves. Here, we report a case of an olfactory...Objective Intracranial schwannomas are frequently located in the VIII cranial nerve, followed by the V and VII cranial nerves, but are quite rare in the olfactory cranial nerves. Here, we report a case of an olfactory schwannoma and review the literature to improve the diagnosis and treatment of olfactory schwannoma. Methods We report a case of olfactory schwannoma in a 51-year-old Chinese man who experienced dizziness and no other symptoms.Results Magnetic resonance imaging(MRI) showed a neoplastic mass located on the anterior cranial base to the right of the midline and near the cribriform plate and sphenoidal plane. The lesion travelled through the cribriform plate into the nasal cavity. This mass was initially thought to be an olfactory groove meningioma. We performed a craniotomy for surgical excision, and the tumor was completely resected, and the skull base was reconstructed at the same time. There were no complications during surgery, and the patient recovered well. The histopathological diagnosis was a schwannoma.Conclusion Olfactory schwannomas are extremely rare and similar to olfactory ensheating cell tumors, and the immunohistochemical staining of leukocyte antigen 7(Leu7/CD57) can be used to identify them. Although the standard treatment of olfactory schwannoma remains unclear, in all reports, most patients can have excellent prognosis after an effective surgical resection.展开更多
文摘Objectives: Sinonasal schwannomas account for less than 4% of head and neck schwannomas, with the primary treatment modality being surgical excision via external approaches. The aim of this report is to present a rare case of recurrent schwannoma of the ethmoid cavity involving the anterior skull base which was successfully managed with endoscopic resection. Study Design: Case report and review of the literature. Methods: The clinical presentation, radiographic features, histopathologic characteristics, surgical approach, and patient outcome were examined in the context of a literature review. Results: A 43-year-old woman presented with a 9-month history of left facial pain and pressure. She had a prior history of sinonasal schwannoma excision with cerebrospinal fluid (CSF) leak repair via bifrontal craniotomy in 2007. Magnetic resonance imaging (MRI) and nasal endoscopy revealed a left ethmoid mass measuring 2.2 cm × 2.7 cm × 2.4 cm abutting the anterior skull base. The tumor was completely removed using a transnasal endoscopic approach, and the anterior skull base reconstructed with tensor fascia lata graft. Histology of the specimen showed schwannoma, and there has been no evidence of tumor recurrence nor CSF leak after 24 months of follow-up. Conclusion: With continual advances in surgical technique and instrumentation, sinonasal schwannomas have become increasingly more amenable to endoscopic resection even in the case of recurrence and skull base involvement.
文摘Objective Intracranial schwannomas are frequently located in the VIII cranial nerve, followed by the V and VII cranial nerves, but are quite rare in the olfactory cranial nerves. Here, we report a case of an olfactory schwannoma and review the literature to improve the diagnosis and treatment of olfactory schwannoma. Methods We report a case of olfactory schwannoma in a 51-year-old Chinese man who experienced dizziness and no other symptoms.Results Magnetic resonance imaging(MRI) showed a neoplastic mass located on the anterior cranial base to the right of the midline and near the cribriform plate and sphenoidal plane. The lesion travelled through the cribriform plate into the nasal cavity. This mass was initially thought to be an olfactory groove meningioma. We performed a craniotomy for surgical excision, and the tumor was completely resected, and the skull base was reconstructed at the same time. There were no complications during surgery, and the patient recovered well. The histopathological diagnosis was a schwannoma.Conclusion Olfactory schwannomas are extremely rare and similar to olfactory ensheating cell tumors, and the immunohistochemical staining of leukocyte antigen 7(Leu7/CD57) can be used to identify them. Although the standard treatment of olfactory schwannoma remains unclear, in all reports, most patients can have excellent prognosis after an effective surgical resection.
