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.