Benign schwannoma in paranasal sinuses: a clinico-pathological study of five cases, emphasising diagnostic difficulties

J Laryngol Otol. 2008 Jun;122(6):598-602. doi: 10.1017/S0022215107000527. Epub 2007 Aug 17.

Abstract

Objectives: To highlight the difficulty in making a correct diagnosis of benign schwannoma in the paranasal region, to raise awareness of this rare condition, and to suggest the most appropriate treatment.

Method: Retrieval of cases retrospectively from archives of the histopathology department of a major UK cancer centre with central review of all cases.

Results: Five cases were identified since 1990 and clinical and pathological features are summarised. Median follow up of patients was 8.1 years. Radiological appearances of local bone invasion and histological features of tumour unencapsulation and hypercellularity could give the mistaken impression of malignant disease and lead to unnecessary over-treatment.

Conclusion: Central pathological review and clinical awareness is required. Although local recurrence can occur, the prognosis is excellent. The treatment of choice is local excision. Radiotherapy can be considered, but in most cases it would incur unnecessary morbidity.

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Differential
  • England
  • Ethmoid Sinus / diagnostic imaging
  • Ethmoid Sinus / pathology*
  • Ethmoid Sinus / surgery
  • Female
  • Humans
  • Male
  • Maxillary Sinus Neoplasms / diagnostic imaging
  • Maxillary Sinus Neoplasms / pathology
  • Maxillary Sinus Neoplasms / surgery
  • Middle Aged
  • Neurilemmoma / diagnostic imaging
  • Neurilemmoma / pathology*
  • Neurilemmoma / surgery
  • Paranasal Sinus Neoplasms / diagnostic imaging
  • Paranasal Sinus Neoplasms / pathology*
  • Paranasal Sinus Neoplasms / surgery
  • Retrospective Studies
  • Tomography, X-Ray Computed