Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.

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Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.

World Neurosurg. 2018 Jan 09;:

Authors: Yoneoka Y, Akiyama K, Seki Y, Hasegawa G, Kakita A

Abstract
BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge.
CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove (OG) with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus. A gadolinium-enhanced T1-weighted magnetic resonance image revealed a well-defined heterogeneously enhanced tumor situated in the midline anterior cranial fossa and the anterior ethmoid sinus. After the resection, the defect of the right anterior skull base was reconstructed with a fascia graft and adipose tissue taken from the abdomen as well as a pedicle periosteum flap. A histological examination revealed the tumor as schwannoma. Her rhinorrhea completely resolved. She regained sense of smell and taste one month after the operation.
CONCLUSION: According to previous reports, para/peri-OG schwannomas can be divided into four types: subfrontal; nasoethomoidal; frontoethomoidal; and ethomofrontal. Among them, a frontoethomoidal schwannoma can manifest exertional CSF rhinorrhea as an initial symptom.

PMID: 29330076 [PubMed - as supplied by publisher]

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