Abstract
Purpose
To present the second known case of nasal alar schwannoma, first since 1973, with important considerations for surgical management.
Case Report
We present the case of a 25-year-old male with a 5-year history of progressively enlarging, non-tender, right alar mass with resultant ipsilateral nasal congestion and dyspnea secondary to nasal valve collapse. The mass was located cephalic to the mid-lateral aspect of the lower lateral crural cartilage, which extended to the pyriform aperture. The mass was removed in an en bloc fashion using an endonasal rhinoplasty approach with placement of an alar batten graft for valve stabilization. The surgical pathology of the mass was consistent with schwannoma.
Conclusion
Regardless of the rarity, schwannoma should remain on the list of possible etiologies for a nasal alar mass. Depending on the size and concurrent mass effect, the external nasal valve may be compromised requiring careful evaluation and operative stabilization for optimal postsurgical outcome.
Level of Evidence V
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References
Kransdorf MJ (1995) Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 164:395–402
Murphey MDSW, Smith SE, Kransdorf MJ, Temple HT (1999) From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 19:1253–1280
Hasegawa SL, Mentzel T, Fletcher CD (1997) Schwannomas of the sinonasal tract and nasopharynx. Mod Pathol 10:777–784
Johncilla M, Jo VY (2016) Soft tissue tumors of the sinonasal tract. Semin Diagn Pathol 33:81–90
Lee EJ, Kim MK, Kang MS, Kim KS (2016) Nasal tip schwannoma coexisting with vestibular schwannoma. J Craniofac Surg 27:e626–e627
Bhargava KB, Gadre KC, Mundada PS (1973) Multiple neurilemmomas in the ala nasi. J Laryngol Otol 87:823–826
Acknowledgements
We offer special thanks to Norris Nolan, MD (Pathology Department at Suburban Hospital, Bethesda, MD) for providing the histological photos used in Fig. 2 of this paper.
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The views herein are the private views of the authors and do not reflect the official views of the Department of the Army or the Department of Defense. The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Blood, T.C., Townes, T.G. & Desai, S.C. Nasal Alar Schwannoma: An Unusual Case Report. Aesth Plast Surg 42, 1101–1103 (2018). https://doi.org/10.1007/s00266-018-1089-y
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DOI: https://doi.org/10.1007/s00266-018-1089-y