Transoral Endoscopic-Assisted Resection of Laryngeal Schwannoma: A Case Report

Document Type : Case Report

Authors

Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Abstract

Introduction:
Schwannoma, a peculiar benign nerve sheath tumour, is frequently hard to differentiate from other nerve tumours, such as neurofibroma. Around 25%-45% of all schwannomas emerge in the head and neck region, but only 0.1-1.5 % involve laryngeal structure. This tumour is most accurately diagnosed with biopsy via direct laryngoscopy; however, at some points this approach cannot detect a definitive diagnosis due to the surrounding capsule of the tumour and its similar histopathologic finding with other nerve sheath tumour.
Case Report:
Here, a case of 56-year-old female is reported with chief complaints of severe progressive dyspnea and dysphagia. Diagnosis of schwannoma was confirmed on radiological and histopathological examination with certain hurdles. A complete surgical excision via endoscopic approach was done, revealing that the bottom of the mass was attached to the right arytenoid mucosa. The histopathological features showed non-malignant atypical neurofibroma but later confirmed as laryngeal schwannoma from immunohistochemical staining.
Conclusion:
Although schwannoma has an excellent outcome and prognosis when occurring elsewhere in the body, laryngeal involvement is an extremely rare area for this lesion. Complete resection with a patient-customized approach to the lesion is required to avoid relapses and provide good functional results.

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