Schwannoma Arising in Nasopharynx: A Case Report and Literature Review

Overview

Journal Indian J Otolaryngol Head Neck Surg

Publisher Springer

Date 2022 Dec 1

PMID 36452824

Authors

Kangsadarn Tanjararak

Navarat Tangbumrungtham

Sirithep Plumworasawat

Boonsam Roongpuvapaht

Affiliations

Soon will be listed here.

Abstract

Schwannoma in paranasal sinus has been known as a rare tumor in this origin. This study reports on primary schwannoma arising in the nasopharynx, which is an uncommon location. A 36-year-old female presented with nasal obstruction for one month. Physical examination revealed a nasopharyngeal mass totally occluding bilateral posterior choanae and extended downward to the oropharynx. Magnetic resonance image showed heterogeneous enhancing mass at the nasopharynx extending inferiorly to the oropharynx. The tumor was excised via endoscopic combined trans-nasal/trans-oral approach under general anesthesia. The pathologic diagnosis was consistent with schwannoma. The tumor was successfully excised with en-block resection and the patient was discharged the next day after the operation, without any postoperative complications. There was no tumor recurrence at 12-months follow-up. Schwannoma primarily arising in the nasopharynx is uncommon. Minimally-invasive surgery via the endoscopic approach can be applied for tumor removal with fewer complications and reduced risk of morbidity.

References

Al-Sheibani S, Zanation A, Carrau R, Prevedello D, Prokopakis E, McLaughlin N . Endoscopic endonasal transpterygoid nasopharyngectomy. Laryngoscope. 2011; 121(10):2081-9. DOI: 10.1002/lary.22165. View

Sheikh H, Chakravarthy R, Slevin N, Sykes A, Banerjee S . Benign schwannoma in paranasal sinuses: a clinico-pathological study of five cases, emphasising diagnostic difficulties. J Laryngol Otol. 2007; 122(6):598-602. DOI: 10.1017/S0022215107000527. View

Wei W, Lam K, Sham J . New approach to the nasopharynx: the maxillary swing approach. Head Neck. 1991; 13(3):200-7. DOI: 10.1002/hed.2880130306. View

Liu H, Yu S, Li G, Wei W . Extracranial head and neck Schwannomas: a study of the nerve of origin. Eur Arch Otorhinolaryngol. 2011; 268(9):1343-7. PMC: 3149663. DOI: 10.1007/s00405-011-1491-4. View

Roger V, Patron V, Moreau S, Kanagalingam J, Babin E, Hitier M . Extended endonasal approach versus maxillary swing approach to the parapharyngeal space. Head Neck. 2018; 40(6):1120-1130. DOI: 10.1002/hed.25092. View

Tanjararak K, Upadhyay S, Thiensri T, Muto J, Roongpuvapaht B, Prevedello D . Potential Surgical Exposure of the Parapharyngeal Internal Carotid Artery by Endonasal, Transoral, and Transcervical Approaches. J Neurol Surg B Skull Base. 2018; 79(3):241-249. PMC: 5951707. DOI: 10.1055/s-0037-1607289. View

Rasbridge S, BROWSE N, TIGHE J, Fletcher C . Malignant nerve sheath tumour arising in a benign ancient schwannoma. Histopathology. 1989; 14(5):525-8. DOI: 10.1111/j.1365-2559.1989.tb02189.x. View

Buob D, Wacrenier A, Chevalier D, Aubert S, Quinchon J, Gosselin B . Schwannoma of the sinonasal tract: a clinicopathologic and immunohistochemical study of 5 cases. Arch Pathol Lab Med. 2003; 127(9):1196-9. DOI: 10.5858/2003-127-1196-SOTSTA. View

Schwartz T, Bruce J . Extended frontal approach with bilateral orbitofrontoethmoidal osteotomies for removal of a giant extracranial schwannoma in the nasopharynx, sphenoid sinus, and parapharyngeal space. Surg Neurol. 2001; 55(5):270-4. DOI: 10.1016/s0090-3019(01)00419-0. View

10.

Wei W, Chan J, Ng R, Ho W . Surgical salvage of persistent or recurrent nasopharyngeal carcinoma with maxillary swing approach - Critical appraisal after 2 decades. Head Neck. 2010; 33(7):969-75. DOI: 10.1002/hed.21558. View

11.

Becker A, Hwang P . Endoscopic endonasal anatomy of the nasopharynx in a cadaver model. Int Forum Allergy Rhinol. 2012; 3(4):319-24. DOI: 10.1002/alr.21104. View

12.

Gupta S, Sachin J, Savyasachi S, Ritesh J, Neha G, Singh H . Solitary nasal schwannoma clinically presenting as an angiofibroma of the nasopharynx. Ear Nose Throat J. 2010; 89(7):E28-30. DOI: 10.1177/014556131008900706. View

13.

Som P, Biller H, Lawson W, Sacher M, Lanzieri C . Parapharyngeal space masses: an updated protocol based upon 104 cases. Radiology. 1984; 153(1):149-56. DOI: 10.1148/radiology.153.1.6089262. View

14.

Fisch U . The infratemporal fossa approach for nasopharyngeal tumors. Laryngoscope. 1983; 93(1):36-44. DOI: 10.1288/00005537-198301000-00007. View

15.

Wei W, Ho C, Yuen P, Fung C, Sham J, Lam K . Maxillary swing approach for resection of tumors in and around the nasopharynx. Arch Otolaryngol Head Neck Surg. 1995; 121(6):638-42. DOI: 10.1001/archotol.1995.01890060036007. View

16.

Kim Y, Kim H, Kim C, Kim J . CT and MR imaging findings of sinonasal schwannoma: a review of 12 cases. AJNR Am J Neuroradiol. 2012; 34(3):628-33. PMC: 7964917. DOI: 10.3174/ajnr.A3257. View

17.

Cohen L, Schwartz A, ROCKOFF S . Benign schwannomas: pathologic basis for CT inhomogeneities. AJR Am J Roentgenol. 1986; 147(1):141-3. DOI: 10.2214/ajr.147.1.141. View

18.

Tu G, Hu Y, Xu G, Ye M . Salvage surgery for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1988; 114(3):328-9. DOI: 10.1001/archotol.1988.01860150110026. View

19.

Younis R, Gross C, Lazar R . Schwannomas of the paranasal sinuses. Case report and clinicopathologic analysis. Arch Otolaryngol Head Neck Surg. 1991; 117(6):677-80. DOI: 10.1001/archotol.1991.01870180113022. View

20.

To E, Teo P, Ku P, Pang P . Nasopharyngectomy for recurrent nasopharyngeal carcinoma: an innovative transnasal approach through a mid-face deglove incision with stereotactic navigation guidance. Br J Oral Maxillofac Surg. 2001; 39(1):55-62. DOI: 10.1054/bjom.2000.0479. View