gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

Olfactory schwannoma – Case report and review of the literature

Meeting Abstract

  • Johanna Quick - Klinik für Neurochirurgie, Goethe-Universität Frankfurt
  • Elke Hattingen - Edinger Institut (Neurologisches Institut), Goethe-Universität Frankfurt
  • Patrick N. Harter - Institut für Neuroradiologie, Goethe-Universität Frankfurt
  • Claire Delbridge - Institut für Pathologie, Abteilung für Neuropathologie, TU München
  • Volker Seifert - Klinik für Neurochirurgie, Goethe-Universität Frankfurt
  • Gerhard Marquardt - Klinik für Neurochirurgie, Goethe-Universität Frankfurt

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 087

doi: 10.3205/13dgnc504, urn:nbn:de:0183-13dgnc5047

Veröffentlicht: 21. Mai 2013

© 2013 Quick et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objective: Tumors involving the frontal base are most often meningiomas, carcinomas, or esthesioneuroblastomas. In this report, the authors present the rare case of a female harbouring a cellular schwannoma of the olfactory nerve.

Method: This 64-year-old woman presented with a history of 6 months permanent headache that constantly increased and finally reached an intensity of 10 on the VAS (visual analog scale). No neurological deficits were found except for a left-sided hitherto unperceived anosmia. MR imaging revealed a large, extra axial tumor of the frontal base invading into the nasal cavity. The tumor presented as partly solid, homogenously enhancing mass with further cystic areas. T2-weighted images revealed marked oedema in the surrounding brain tissue. Supposed diagnoses were meningioma or esthesioneuroblastoma, and the patient was subjected to surgery. Using a bicoronar skin incision a bifrontal approach was performed. After visualization of the tumor it instantaneously became evident that it was not a meningioma. The tumor was yellowish and of a hard structure and did not show any attachment to the dura. It was purely extra-axial and could be dissected from the surrounding brain tissue with ease. It is noteworthy that the left-sided olfactory nerve was completely destroyed by the tumor. After gross total resection of the tumor a complex frontobasal reconstruction was performed, and the postoperative course was uneventful.

Results: Histopathological examination of the resected tissue revealed a tumor with predominantly high cellular density and focal loosened texture. The cells were mainly spindle-shaped and showed focal mitotic activity. Besides strong S100 immunoreactivity, tumor cells showed a pericellular reticulin pattern and predominantly expressed CD57 but as well GFAP in a patchy fashion. Final histopathological diagnosis was cellular schwannoma WHO Grade I.

Conclusions: Even though of very rare occurrence we propose to consider not only olfactory ensheathing cell tumor but also olfactory nerve schwannoma as differential diagnosis in the event of frontal base tumor.