Ethmoid Schwannoma: about the management of a rare tumor of sinonasal cavities manifested by an orbital complication

We report a rare sinonasal tumor initially manifesting with orbital cellulitis with impaired oculomotricity and take stock of the management methods. Here, we present the case of a 72-year-old patient presenting to the ophthalmology emergency department with acute orbital cellulitis. Computed tomography revealed an ethmoidal mass associated with frontoethmoidal muco-pyocele. It was fully removed endoscopically, and a pathological diagnosis of ethmoid schwannoma was made. Magnetic resonance imaging after ten months showed no sign of recurrence. The patient presented with an acute orbital cellulitis with acute loss of visual acuity and impaired oculomotricity within 24 hours, associated with fever and local pain. Tomodensitometry showed a large heterogeneous tumor arising from the anterior ethmoid sinus and extending to the frontoethmoidal recess and the orbital cavity with lamination of lamina papyracea. The tumor was removed by endonasal radical excision. The final pathological analysis revealed benign schwannoma. There was no sign of recurrence or late complication during the 10-month follow-up. Schwannomas of the nasal cavities are rare tumors but must be mentioned among the differential diagnoses of endonasal and endosinusal masses, sometimes observed with orbital complications. On the basis of the location and extension, endoscopic resection is a valid strategy.

Cite this article as: Rogister F, Peigneux N, Tombu S. Ethmoid Schwannoma: about the management of a rare tumor of sinonasal cavities manifested by an orbital complication. B-ENT 2021; 17(4): 260-3.