Neurilemmomas of the paranasal sinuses

Within the head and neck region, neurilemmomas are rarely found in the nasa l cavity or paranasal sinuses. A 70-year-old man presented with complaints of left-sided epiphora, rhinorrhea, epistaxis, and transient diplopia, Nasa l endoscopy showed a large necrotic mass filling the left middle meatus. A computed tomography scan showed a large left ethmoid mass, with erosion of the medial wall of the orbit and the anterior cranial base. Multiple biopsi es were nondiagnostic. Complete excision of the tumor was performed with en doscopic techniques. Small dural defects were repaired with a middle turbin ate mucosal flap. Postoperatively, the patient was treated with nasal packi ng and a lumbar spinal drain. Final pathology showed a benign neurilemmoma. There has been no evidence of recurrence or cerebrospinal fluid leakage in follow-up. A review of the literature shows a similar presentation of pati ents with neurilemmomas of the paranasal sinuses. Bony destruction and intr acranial extension is viewed. Lack of encapsulation and locally destructive growth in an otherwise histologically typical neurilemmoma should not sugg est malignant potential. Many benign tumors of the paranasal sinuses with b one destruction may be removed by using endoscopic techniques. (Am J Otolar yngol 2001;22:215-218. Copyright (C) 2001 by W.B. Saunders Company).