A rare presentation of Intralaryngeal Schwannoma and the study of 50 cases of intralaryngeal Schwannoma from the literature

Authors

  • Raghavendra Prasad K. U. Department of Otorhinolaryngology, Hassan Institute of Medical Sciences, Karnataka, India
  • Shreyanka M. Doreswamy Department of Otorhinolaryngology, Hassan Institute of Medical Sciences, Karnataka, India
  • Manohar S. Ramanaik Department of Otorhinolaryngology, Hassan Institute of Medical Sciences, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20222679

Keywords:

Schwannoma, Larynx, Neurogenic tumour, Supraglottis

Abstract

Background: Laryngeal schwannoma is a rare, slow-growing, benign neurogenic tumour usually located in the aryepiglottic folds. The aim is to report a rare case of laryngeal schwannoma and to review 50 cases of a similar entity from the literature in terms of age, sex, presenting symptoms, site, size, the nerve of origin, mode of surgery and outcome.

Methods: A retrospective study was conducted at the Department of Otorhinolaryngology, in a tertiary care centre along with a review of cases from the literature. A detailed description of the case of laryngeal schwannoma in a 20-year-old patient, who presented with difficulty in swallowing, dyspnoea and hoarseness in the voice to the department of otorhinolaryngology will be given. Along with the data on a comprehensive literature search on about 50 cases of laryngeal schwannomas.  

Results: Out of the 50 cases, 54% were females and the majority of the cases were above the age of 55 years. Aryepiglottic folds were the common site of tumours (38%). Other sites where the tumour was found included the false cords, true vocal cords, ventricle, arytenoids, epiglottis, post cricoid region, trachea, and thyroid gland. All cases were treated surgically.

Conclusions: Laryngeal schwannomas are rare, nerve sheath tumours usually located in the supraglottic larynx. The surgical approach depends on the site, size and extent of the tumour. Sparing the parental nerve depends on the size of the tumour and the nerve of origin.

Author Biography

Raghavendra Prasad K. U., Department of Otorhinolaryngology, Hassan Institute of Medical Sciences, Karnataka, India

Professor and Head of the Department

Department of Otorhinolaryngology and Head & Neck Surgery

Hassan Institute of Medical Sciences, Hassan, Karnataka, India.

References

Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM. Malignant peripheral nerve sheath tumours. A clinicopathologic study of 120 cases. Cancer. 1986;57(10):2006-21.

Ebmeyer J, Reineke U, Gehl HB, Hamberger U, Mlynski R, Essing M, Upile T, Sudhoff H. Schwannoma of the larynx. Head Neck Oncol. 2009;1(1):24.

Jamal MN. Schwannoma of the larynx: case report, and review of the literature. J Laryngol Otol. 1994;108(9):788-90.

Zbäuren P, Markwalder R. Schwannoma of the true vocal cord. Otolaryngol—Head Neck Surg. 1999;121(6):837-9.

Zhang H, Cai C, Wang S, Liu H, Ye Y, Chen X. Extracranial head and neck schwannomas: a clinical analysis of 33 patients. The Laryngoscope. 2007;117(2):278-81.

de Araujo CE, Ramos DM, Moyses RA, Durazzo MD, Cernea CR, Ferraz AR. Neck nerve trunks schwannomas: clinical features and postoperative neurologic outcome. The Laryngoscope. 2008;118(9):1579-82.

Meriç F, Arslan A, Cüreoğlu S, Nazaroğlu H. Schwannoma of the larynx: case report. Eur Arch Oto-rhino-laryngol. 2000;257(10):555-7.

Gupta TD, Brasfield RD. Solitary malignant schwannoma. Ann Surg. 1970;171(3):419.

Nakayama H, Gobara Y, Shimamoto F, Kajihara H. Ancient schwannoma of the oral floor and ventricular portion of the tongue: a case report and review of the literature. Japanese J Clin Oncol. 1996;26(3):185-8.

Whittam DE, Morris TM. Neurilemmoma of the larynx. J Laryngol Otol. 1970;84(7):747-50.

Stout AP. Tumours of the peripheral nervous system. National Academies. 1949.

Gardner PM, Jentzen JM, Komorowski RA, Harb JM. Asphyxial death caused by a laryngeal schwannoma: a case report. J Laryngol Otol. 1997;111(12):1171-3.

Kanatas A, Mücke T, Houghton D, Mitchell DA. Schwannomas of the head and neck. Oncol Rev. 2009;3(2):107-11.

Lo S, Ho WK. Schwannoma of the larynx-an uncommon cause of vocal cord immobility. Hong Kong Med J. 2004;10(2):131-3.

Enzinger FM. Benign tumours of peripheral nerves. Soft tissue tumours. 1995;821-88.

Ferlito A. Atypical forms of squamous cell carcinoma. Neoplasms of the Larynx. New York: Churchill Livingstone. 1993;135-67.

Wong BL, Bathala S, Grant D. Laryngeal schwannoma: a systematic review. Eur Arch Oto-Rhino-Laryngol. 2017;274(1):25-34.

Martin PA, Church CA, Chonkich G. Schwannoma of the epiglottis: first report of a case. Ear, Nose Throat J. 2002;81(9):662-3.

Plantet MM, Hagay C, De Maulmont C, Mahé E, Banal A, Gentile A, Cherel P, Mayras C. Laryngeal schwannomas. Eur J Radiol. 1995;21(1):61-6.

López-Álvarez F, Gómez-Martínez JR, Suárez-Nieto C, Llorente-Pendás JL. Schwannoma of the larynx. An infrequent laryngeal tumour. Acta Otorrinolaringologica (English Edition). 2013;64(2):157-60.

Skolnik AD, Loevner LA, Sampathu DM, Newman JG, Lee JY, Bagley LJ, Learned KO. Cranial nerve schwannomas: diagnostic imaging approach. Radiographic. 2016;36(5):1463-77.

Nagata M, Ito H, Matsuzaki T, Furumoto H, Isaka T, Nishii T, Yokose T, Nakayama H. Plexiform schwannoma involving the trachea and recurrent laryngeal nerve: a case report. Surg Case Rep. 2015;1(1):1-4.

Relić N, Jevtić M, Belić B, Petrović-Rodić D, Jevtović A, Božović N, Jovanović M, Stojanović J. Presentation of a rare case of laryngeal schwannoma with short literature review. Vojnosanitetski Pregled. 2021;86.

Kamble BB, Deshmukh P, Methwani D, Lakhotia P. A Rare Case of Laryngeal Schwannoma. Ann Clin Case Rep. 2017;2:1364.

Kennedy WP, Brody RM, LiVolsi VA, Wang AR, Mirza NA. Trauma‐induced schwannoma of the recurrent laryngeal nerve after thyroidectomy. The Laryngoscope. 2016;126(6):1408-10.

Kayhan FT, Kaya KH, Ylmazbayhan ED. Transoral robotic approach for schwannoma of the larynx. J Craniofac Surg. 2011;22(3):1000-2.

Millas T, Granell J, Garrido L, Mendez‐Benegassi I, Gutierrez‐Fonseca R. Transoral robotic approach for laryngeal schwannoma. Head & Neck. 2015;37(6):E70-3.

Selmani Z, Ilomäki J, Ashammakhi N. Longstanding recurrent paresis of the left false vocal cord secondary to a schwannoma relieved with laryngoscopic tumour removal. Eur J Plastic Surg. 2003;26(6):326-7.

Nagato T, Katada A, Yoshizaki T, Kunibe I, Takahara M, Katayama A, Hayashi T, Harabuchi Y. Laryngeal plexiform schwannoma as the first symptom in a patient with neurofibromatosis type 2. Clin Neurol Neurosurg. 2010;112(6):505-8.

Chiu CC, Chou SH, Wu CC, Liang PI, Lee KW. Obstructive laryngeal schwannoma in a young female. World J Surg Oncol. 2015;13(1):1-6.

Mannarini L, Morbini P, Bertino G, Gatti O, Benazzo M. Acute respiratory distress in a patient with laryngeal schwannoma. Case Rep Med. 2012.

Rosen FS, Pou AM, Quinn Jr FB. Obstructive supraglottic schwannoma: a case report and review of the literature. The Laryngoscope. 2002;112(6):997-1002.

Souza LR, De Nicola H, Yamasaki R, Pedroso JE, Brasil OD, Yamashita H. Laryngeal schwannoma: a case report with emphasis on sonographic findings. Radiologia Brasileira. 2014;47:191-3.

Romak JJ, Neel III HB, Ekbom DC. Laryngeal schwannoma: a case presentation and review of the mayo clinic experience. J Voice. 2017;31(1):129-35.

Ramakrishnan Y, Issing WJ. Laryngeal schwannoma: case report and literature review. Int Scholarly Res Notices. 2011;540643.

Wang B, Dong P, Shen B, Xu H, Zheng J. Laryngeal schwannoma excised under a microlaryngoscope without tracheotomy: a case report. Exp Therap Med. 2014;7(4):1020-2.

Tulli M, Bondi S, Smart CE, Giordano L, Trimarchi M, Galli A, Di Santo D, Biafora M, Bussi M. Diagnosis and treatment of laryngeal schwannoma: a systematic review. Otolaryngology-Head Neck Surg. 2018;158(2):222-31.

Tulli M, Bondi S, Bussi M. Voluminous laryngeal schwannoma excision with a mini-invasive external approach: a case report. Acta Otorhinolaryngologica Italica. 2017;37(3):242.

Ueha RI, Nishimura S, Nito T. Laryngeal schwannoma with extra laryngeal extension. Auris Nasus Larynx. 2012;39(3):317-20.

Kou W, Zhang C, Wei P. Laryngeal schwannoma treated with a CO2 laser: A case report. Oncology letters. 2015;9(3):1467-9.

Saita V, Azzolina A, Galia A, Fraggetta F. Schwannoma of the epiglottis: case report focusing on clinicopathological aspects. Acta otorhinolaryngologica italica. 2005;25(6):378.

Rognone E, Rossi A, Conte M, Nozza P, Tarantino V, Fibbi A, Saetti R, Cutrone C, Tortori‐Donati P. Laryngeal schwannoma in an 8‐year‐old boy with inspiratory dyspnea. Head & Neck. 2007;29(10):972-5.

Syeda F, Hussain A. Schwannoma of the larynx: a case report. Ear, Nose Throat J. 2005;84(11):732-4.

Moroni AL, Righini C, Faure C, Serra-Tosio G, Lefournier V. CT Features of an unusual calcified schwannoma of the superior laryngeal nerve. Am J Neuroradiol. 2007;28(5):981-2.

Costa CC, Ramos HV, Alves W, Lamounier P, de Castro Velasco L, El Cheikh MR. Partial laryngectomy and reconstruction with rotation of the epiglottis in the treatment of a rare laryngeal schwannoma: a case report. J Med Case Rep. 2020;14(1):1-4.

Tritter AG, Sadoughi B. Transoral Laser Microsurgical Excision of a Laryngeal Schwannoma Located in the Paraglottic Space. The Laryngoscope. 2021;131(12):2729-31.

Tse A, Anwar B. Laryngeal schwannoma: excision via a laryngofissure approach. J Surg Case Rep. 2015;6:rjv059.

Cohen S, Sinacori JT, Courey MS. Laryngeal schwannoma: diagnosis and management. Otolaryngology-Head Neck Surg. 2004;130(3):363-5.

Vital I, Fliss DM, Cohen JT. Laryngeal schwannoma excised under direct laryngoscopy: case report. Ear, Nose Throat J. 2012;91(5):204-5.

Taylor J, Stiefel M, Park SY. Schwannoma of the true vocal fold: a rare diagnosis. Ear, Nose Throat J. 2006;85(1):52-9.

Chandrashekhara SH, Bhalla AS, Kartikeyan KV, Shukla B, Safaya R. Vocal cord schwannoma: A rare case report. J Cancer Res Therap. 2010;6(4):543.

El Fakiri MM, Rochdi Y, Abdala FZ, Nouri H, Raji A. Voluminous laryngeal schwannoma treated with endoscopic laser approach. Turkish Arch Otorhinolaryngol. 2020;58(1):52.

Park KT, Ahn Y, Kim KH, Kwon TK. Schwannoma mimicking laryngocele. Clin Exp Otorhinolaryngol. 2010;3(3):166.

Palva T, Jokinen K, Kärjä J. Neurilemmoma (schwannoma) of the laynx. J Laryngol Otol. 1975;89(2):203-7.

Mariani C, Carta F, De Seta D, Nazhmudinov II, Guseinov IG, Magomedova KM, Chuchueva N, Marrosu V, Puxeddu R. Transoral‐transpharyngeal CO2 laser en bloc excision of voluminous left recurrent laryngeal nerve schwannoma: Case report and review of the literature. Clin Case Rep. 2020;8(12):3198.

Sanghvi V, Lala M, Borges A, Rodrigues G, Pathak KA, Parikh D. Lateral thyrotomy for neurilemmoma of the larynx. J Laryngol Otol. 1999;113(4):346-8.

Mikoshi A, Edo H, Hase T, Sakima T, Uno K, Kumazawa F, Sato K, Shinmoto H. Laryngeal schwannoma with extra laryngeal extension mimicking a thyroid tumour. BJR| Case Rep. 2021;7:20210089.

Newton JR, Ruckley RW, Earl UM. Laryngeal neurilemmoma: a case report. Ear, Nose Throat J. 2006;85(7):448-9.

Park JY, Seo CH, Lim SY, Seong H, Jang KJ, Lee DG, Lee CW. Laryngeal schwannoma: a case report. J Korean Radiol Soc. 1999;41(1):27-30.

Tzagkaroulakis A, Stivaktakis J, Nikolopoulos T, Davilis D, Zervoudakis D. Ancient schwannoma of the true vocal cord. ORL. 2003;65(5):310-3.

McHenry LC. XXXVII Neurilemmoma (Schwannoma) of the Larynx. Ann Otol Rhinol Laryngol. 1953;62(2):392-9.

Ash L, Srinivasan A, Mukherj SK. Radiological Reasoning: submucosal laryngeal mass. Am J Roentgenol. 2008;191(3):18-21.

Downloads

Published

2022-10-26

Issue

Section

Original Research Articles