# Malignant peripheral nerve sheath tumor of the nasal cavity: a rare diagnostic and therapeutic challenge

**Authors:** Amine Oussalem, Anas Azgaoui, Bouchra Dani, Malik Boulaadas

PMC · DOI: 10.1093/jscr/rjaf349 · Journal of Surgical Case Reports · 2025-05-30

## TL;DR

This paper presents a rare case of a nasal cavity tumor in an elderly patient, highlighting the challenges in diagnosing and treating aggressive nerve sheath tumors.

## Contribution

The paper adds a rare clinical case of MPNST in the nasal cavity and emphasizes the importance of early surgical intervention and chemotherapy.

## Key findings

- MPNSTs should be considered in the differential diagnosis of nasal masses in elderly smokers.
- Surgical resection followed by chemotherapy is recommended for better outcomes.
- The tumor's aggressive nature was evident as the patient passed away shortly after diagnosis.

## Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive sarcomas, often affecting the head and neck, with higher incidence in neurofibromatosis type 1. Early diagnosis is crucial to prevent recurrence and metastasis. We report a 78-year-old male with a rapidly enlarging right nasal cavity mass over 4 months, associated with recurrent epistaxis. His medical history included diabetes, hypertension, and tobacco use. Examination revealed a firm, non-adherent mass obstructing the nasal cavity. Computed tomography (CT) imaging localized it to the right inferior turbinate. Due to size and location, biopsy was not performed. Surgical resection confirmed a high-grade MPNST (FNCLCC grade 3). Chemotherapy was initiated postoperatively, but the patient passed away soon after, highlighting the tumor’s aggressiveness. MPNSTs should be considered in nasal mass differentials, especially in elderly smokers. Early surgery and chemotherapy may improve outcomes, emphasizing the need for a multidisciplinary approach.

## Linked entities

- **Diseases:** malignant peripheral nerve sheath tumor (MONDO:0004345), neurofibromatosis type 1 (MONDO:0018975), diabetes (MONDO:0005015)

## Full-text entities

- **Genes:** NF1 (neurofibromin 1) [NCBI Gene 4763] {aka NFNS, VRNF, WSS}
- **Diseases:** metastasis (MESH:D009362), diabetes (MESH:D003920), hypertension (MESH:D006973), sarcomas (MESH:D012509), nasal mass (MESH:D009668), MPNST (MESH:D018319), tumor (MESH:D009369)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12122282/full.md

## References

10 references — full list in the complete paper: https://tomesphere.com/paper/PMC12122282/full.md

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Source: https://tomesphere.com/paper/PMC12122282