Pyriform Fossa Schwannoma: A Rare Case Report

Case Report
Khaja Naseeruddin., Seema Monga., Junaid Malik., Ratna Priya., Shahid Rasool and Zeeba Jairajpuri
Pyriform fossa, Schwanomma, Surgical Excision.

Schwannomas are benign slow-growing tumors that arise from the Schwann cells of any peripheral, cranial, or autonomic nerve sheaths. Between 25% and 45% of extracranial schwannomas arise in the head and neck region. The location of Schwannoma or neurofibroma within the larynx and hypopharynx is very uncommon. They represent 0.1% to 1.5% of all benign tumors in larynx and hypopharynx. Here we present a rare case of schwanomma of pyriform fossa in a young female patient. Presenting complaints were hoarseness of voice and difficulty in swallowing. Laryngoscopic examination revealed a smooth submucosal swelling in the left pyriform sinus. Bilateral vocal cord mobility was normal. No lymphadenopathy was detected. Contrast enhanced computerised tomography of the neck showed a well marginated hypodense lesion showing progressive enhancement with non enhancing central mass in supraglottic and pyriform sinus on left side extending superiorly from epiglottis and reaching inferiorly till glottis and right side small laryngocele. Treatment of choice is complete enucleation/excision along with preservation of function of affected nerve/site. Various approaches such as endoscopic, open transoral, and external or lateral pharyngotomy approaches can be used depending on size and location of lesion. The definitive diagnosis relies on clinical suspicion and histopathological confirmation.