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

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.