51-year-old man presented with a few-month history of nasal obstructiv

 

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

 

Case Section

Head & Neck Imaging

 

Patient's Information

Gender : Male
Age : 51

 

Clinical Summary

51-year-old man presented with a few-month history of nasal obstructive symptoms

 

Imaging Findings

Axial non-enhanced CT scan images show an expansile soft-tissue mass posteriosuperiorly in the left nasal cavity causing remodeling and erosion of the nasal septum as well as the lateral nasal wall.On MR images,the mentioned mass demonstrates heterogeneous signal intensity,mostly high on T2- and low on T1-weighted images associated with heterogeneous intense enhancement on contrast-enhanced image and extends up to the ethmoidal air cells.There is no evidence of intracranial or intraorbital extension.Hemorrhagic pituitary macroadenoma is also seen.

 

Differential Diagnosis

1.Inverted papilloma,2.Antrochoanal polyp,3.Juvenile nasopharyngeal angiofibroma,4.Olfactory neuroblastoma,5.Paranasal sinus mucocoele

 

Final Diagnosis

Sinonasal schwannoma

 

Discussion (Related Text)

Sinonasal schwannoma is generally a well-defined soft-tissue mass most frequently occurring in the nasal cavity and ethmoid sinus and frequently associated with pressure remodeling of the adjacent bone. These tumors are isoattenuating on CT and predominantly isointense on both T1- and T2-weighted MR images,compared with the brainstem.Mild contrast enhancement on CT and strong enhancement on MR images were also demonstrated in most of the tumors. Although sinonasal schwannomas are rare and their imaging findings are rather nonspecific, CT and MR imaging studies are helpful for preoperative diagnosis and surgical planning in patients with schwannoma of the sinonasal cavity.

 

References

Y.S. Kim, H.-J. Kim, C.-H. Kim, and J. Kim,F:CT and MR Imaging Findings of Sinonasal Schwannoma,AJNR,34:628–33 ,Mar 2013

 

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