Neurilemmoma of fronto-ethmoid paranasal sinuses: aggressive anterior skull base destructing tumor—a case report

Neurilemmomas (Schwannomas) of sinonasal tract are very unusual. They are benign, slow-growing, usually solitary encapsulated perineural tumors. They arise from Schwann cells of the neural sheath of the peripheral nervous system including motor, sensory and autonomic nerves. They can occur throughout the body, but the head and neck region demonstrate a higher incidence of occurrence (25–45%). The sinonasal region, however, has the lowest incidence rate with only 3–4%. We report here a rare case of fronto-ethmoid sinus neurilemmoma that is locally destructing the anterior skull base and the lateral orbital wall. A left eye proptosis, diplopia and chemosis were the presenting complaints. Images and histopathology examinations confirmed the diagnosis. The patient underwent tumor resection through Endoscopic Endonasal approach, followed by a functional sinus drainage of the retained secretions. The patient made a good postoperative recovery and remained disease free at a 1-year follow up period.