engleski

PERIPHERAL NERVE SHEATH TUMOR OF NASAL SEPTUM - CASE REPORT

We present a case of 62 years old female with unusual tumor of the posterior nasal septum. The patient complained on worsening of nasal breathing last several years. She is diabetic, with appropriately controled glicemia with insuline. Routine nasal examination at the onset of symptoms dis not show evidence of nasal patology. She denied epistaxis, headaches or nasal discharge. Since th nesal obstruction progressed, recent ENT exam showed bulging of posterior septum that obstructed both nasal cavities, but covered with normal mucosa. A CT scan demonstrated rounded tumor occupying posterior septum measering 4 cm in diameter, located just in front of sphenoid rostrum. A biopsy showed tumor composed of myxomatous stroma and numerous vascular spaces. Stroma contained small fusiform to star shaped cells without mitotic activity. Initial finding pointed to "hemangiopericytoma like" tumor. The tumor was completely removed by endoscopical approach. Negative margins were confirmed by intraoperative biopsy. Definitive hystological and immunohistological analysis (IHA) revelaed "hemangiopericytoma like" tumor, but strong reactivity to S 100 seggested a definitive diagnosis of peripheral nerve sheath tumor. Clinical finding of very moderate bleeding during biopsy also supports this diagnosis instead of vascular tumor. Benign peripheral nerve sheath tumors are rare in head and neck area, with only one case arising in the nasal septum, according to literature citet in Medline

nerve sheath tumor

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