Shelesko E.V., Chernikova N.A., Zinkevich D.N., Chernov I.V., Belov A.I., Ryzhova M.V., Panina T.N., Nikonova S.D., Doronina V.A., Abdulgamidov A.H. A rare case of sinonasal neurofibroma with intraorbital spread and destruction of the skull base bones. Head and neck. Russian Journal. 2023;11(1):37– 43
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Neurofibroma is a benign tumor that can develop from any peripheral, cranial, or autonomic nerve that has a Schwann sheath. Neurofibromas can form sporadically or in type I neurofibromatosis. Neurofibroma of the nasal cavity and paranasal sinuses is very rare; only a few cases have been described in the world literature. This article presents a case of diagnosis and successful endoscopic treatment of synonasal neurofibroma.
Clinical case. A 51-year-old woman applied to the N.N. Burdenko National Scientific and Practical Center for Neurosurgery with complaints of difficulty in nasal breathing, recurrent edema of the right eye, impaired sense of smell, headaches. Computed and magnetic resonance tomography revealed a tumor of the nasal cavity involving the ethmoid labyrinth cells on the right with a spread into the orbit and destruction of the skull base bone. She underwent endoscopic endonasal excision of the tumor of the nasal cavity, ethmoid labyrinth cells, orbit on the right with plasty of the skull base defect under the navigation system control.
Conclusions. Neurofibromas are very rare tumors of the nasal cavity and paranasal sinuses. This disease should be differentiated primarily with neuromas, fibromas, hemangiomas, neuromas, and malignant tumors. Endoscopic endonasal excision is the treatment of choice for patients with synonasal neurofibroma. In rare cases, neurofibromas can become malignant, therefore, follow-up is necessary. In case of the intraorbital and/or intracranial tumor spread, it is necessary to have experience in reconstructive osteoplastic surgery to perform radical treatment.
Key words: neuroectodermal tumors, neurofibroma, neuroma, skull base, endoscopic surgery
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study