2. Case Report
A 70-year-old man with unilateral progressive nasal obstruction that started about 2 years ago referred to the otolaryngology department of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. The patient was employed in the textile industry. There was no positive history of nasal trauma, smell disorders, posterior nasal discharge, epistaxis, chronic cough, rhinorrhea, sneezing, headache, diplopia, and facial pain. His past history included a known subject of type 2 diabetes mellitus. Furthermore, his family history was not remarkable. On nasal endoscopy, there was a space-occupying mass in the right nostril that prevented further observation. The remaining ear, larynx, pharynx, head, and neck examinations were normal. Contrast-enhanced computed tomography showed a soft tissue mass (40–45 HU) with mild heterogeneous enhancement in the right nasal cavity with no destructive effect on adjacent structures (Figure1). Endonasal excision of the right nasal cavity mass was done under general anesthesia. Intraoperative observation revealed a pedunculated skin-covered mass originated from the lateral nasal wall. The mass was totally excised and its pedicle was cauterized (Figure2). Homeostasis was achieved and the right nasal cavity was packed with ribbon gauze for 24 hours. The postoperative was uneventful. The microscopic findings of the resected mass lesion show a biphasic neoplasm with a well-defined border and thick capsule (figure 3), composed of spindle cells with narrow, elongated, and wavy nuclei with tapered ends, dense chromatin, and ill-defined cytoplasm arranged in compact hypercellular (Antoni A) areas and myxoid hypocellular (Antoni B) areas (figure 4) with the presence of nuclear palisading, Verocay bodies (figure the pathology report was compatible with schwannoma.