PMC6000765_01
Columellar mass immediately before operation.
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On examination there was a soft, smooth, non-tender expansile lesion over the columella, with mild telangiectasia of the overlying skin (Fig. 1.).
Appearance of columellar lesion on MRI T2 sequencing (axial and sagittal views).
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A non-contrast MRI revealed a 1.9 x 1.4 x 1.1 cm homogeneous mass in the right nasal columella, of high T2 and intermediate T1 signal, abutting the nasal septum with no deeper extension (Fig. 2).
Intra-operative view: dissection of lesion with intact capsule.
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The upper lateral cartilages were not encountered and the lesion was completely excised with the capsule intact (Fig. 3).
Immediate post-operative appearance.
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Recovery following the operation was uneventful with satisfactory cosmetic outcome (Figs. 4 and 5 ).
a. Haematoxylin and eosin stained section showing Antoni A (top) and Antoni B (bottom) areas of the Schwannoma. Verocay bodies composed of palisaded spindle cells are present in the Antoni A areas. b. Immunohistochemistry for S100 showing strong and diffuse staining of the tumour cells. c. Immunohistochemistry for Ki67 (MIB-1) demonstrated a proliferation fraction of 5-8% overall.
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Recovery following the operation was uneventful with satisfactory cosmetic outcome (Figs. 4 and 5 ).