Initially, Doctor Nguyen Chi Trung from the department of otolaryngology performed an endoscopy, which revealed a polyp completely obstructing the left nasal cavity. This was accompanied by significant fluid accumulation in the nasal passages and floor, along with swollen nasal turbinates. A maxillofacial CT scan further identified a soft tissue mass, 24x35 mm, in Huong's left nasal cavity. This mass extended into the left ethmoid and maxillary sinuses, causing thinning of the sinus wall, mucosal thickening, and fluid retention, which led to the obstruction of the left ostiomeatal complex.

Based on these findings, doctors initially diagnosed Huong with a grade 4 left nasal polyp and acute sinusitis, recommending endoscopic surgery. However, pathology results from the surgical specimen confirmed that the nasal lesion was not a common nasal polyp but a schwannoma, also known as a nerve sheath tumor.

Doctor Trung consults Huong about a nasal septum tumor. *Photo: Tam Anh General Hospital*

Schwannomas are typically benign, slow-growing tumors originating from Schwann cells that surround nerve fibers in the central nervous system, spinal cord, and peripheral nerves.

These tumors can occur in various body parts, primarily in the head and neck region. The most common location is the 8th cranial nerve (vestibulocochlear nerve). Additionally, tumors may appear in the face, parotid gland, oral cavity, pharynx, larynx, and trachea. They rarely occur in the nasal and paranasal sinus regions.

Symptoms of sinonasal schwannomas include: nasal congestion, nosebleeds, runny nose, loss of smell, headache, facial swelling, and other symptoms depending on the tumor's location.

Doctor Trung stated that while the recurrence rate after surgical treatment is low, patients still require regular follow-up appointments for long-term monitoring.

Tran Duong

*Patient's name has been changed*