Sinonasal schwannoma with variable presentation: A two-case report

Schwannomas are benign, slow-growing tumors arising from Schwann cells. Extracranial head and neck lesions are uncommon, and sinonasal schwannomas are rare. We report two cases managed at tertiary centers. A 51-year-old man presented with progressive left nasal obstruction and proptosis due to a frontoethmoidal mass abutting the orbit. Endoscopic excision revealed ancient schwannoma, and he remained recurrence-free at three years. A 39-year-old woman with diabetes had right nasal obstruction and mild epistaxis from a posterior septal mass. Coblator-assisted endoscopic excision was performed, and histopathology confirmed schwannoma. Both patients recovered uneventfully. Radiologically, these tumors appear as homogeneous soft-tissue lesions with bony remodeling on CT and contrast enhancement on MRI. Histology demonstrates biphasic Antoni A and B areas with S-100 positivity. These cases emphasize diagnostic pitfalls and surgical considerations in sinonasal schwannomas, especially when mimicking mucoceles or arising near the skull base.