Ancient Schwannoma in the Buccal Region

Tobita, Takayoshi; Ikeda, Hisazumi; Fujita, Shuichi; Ikeda, Mana; Ohba, Seigo; Shibahara, Kiyotaka; Uehara, Masataka; Tajima, N.; Ikeda, Tohru; Asahina, Izumi

doi:10.1016/s0915-6992(08)80035-0

Cited by 8 publications

(3 citation statements)

References 8 publications

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“…Hyalinization, hemorrhage, cyst formation, histiocytes and siderophages infiltration and calcification are among the degenerative processes that characterize it. Some authors relate it with long history as well [ 10 , 12 ] In the current case, most of the microscopic features of the ancient schwannoma were noticed. However, the history of the lesion is not long, 1–2 years.…”

Section: Discussionmentioning

confidence: 65%

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Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Alotaiby

2022

Am J Case Rep

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Objective:Rare disease Background:Schwannoma is an uncommon benign tumor that develops from Schwann cells in the peripheral nervous system; 25-50% of such tumors occur in the head and neck. A rare variety of schwannoma, known as an ancient schwannoma, exhibits calcification, cystic degeneration, hemorrhage, myxoid stroma, pleomorphism, and nuclear hyperchromatism. Such characteristics may contribute to this tumor being incorrectly diagnosed as malignant. Almost all reported intra-oral ancient schwannomas behave innocuously. Case Report:A 20-year-old man presented to the oral surgery clinic with a right facial swelling that began a few months before. CT and MRI were performed and showed a well-defined cystic lesion anterior to the right masseter muscle, located in the subcutaneous area and measuring 28×24×20 mm. No extension to the surrounding tissues nor any other similar lesions were seen. Microscopic examination revealed an encapsulated nodular mass with cystic cavities, hemorrhage, and variably distributed myxoid and hyalinized stroma. The tumor demonstrated 2 distinct cell distributions: hypercellular areas (Antoni A) and myxoid hypocellular areas (Antoni B). Focal areas in high-power magnification showed atypical cells with hyperchromatic and pleomorphic nuclei. The tumor cells showed diffuse positivity for S-100 in IHC. The diagnosis of ancient schwannoma was made. At 1-year follow-up, there was no evidence of nerve injury or recurrence. Conclusions:One more case of oral ancient schwannoma is added to the literature. This is the first reported in Saudi Arabia.It is prudent to be familiar with the degenerative and cytologic alterations of ancient schwannoma, as this may limit the likelihood of misdiagnosis and unnecessary treatment of this benign tumor, with an excellent prognosis.

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Section: Discussionmentioning

confidence: 65%

“…The current lesion was located in the submucosal area of the buccal mucosa, and only 2 previously reported cases had lesions at this location; both were 2 cm in diameter in 66- and 60-year-old patients. The durations of these 2 lesions were 13 and 23 years, respectively, without any complications [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Alotaiby

2022

Am J Case Rep

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“…When such tumors grow larger, however, the following may be observed: a hyaline deposit inside the tumor; a cystic tumor; proliferation of blood vessels; bleeding; calcification; and necrosis. In such cases, the lesion is called an ancient schwannoma, and these are rarely reported in the oral cavity 7,11) . It is possible that secondary change had occurred within the lesion, as several years had lapsed before treatment was commenced, and indeed the MRI findings appear to indicate this.…”

Section: Discussionmentioning

confidence: 99%

Schwannoma Derived from Lingual Nerve Occurring in Floor of Mouth

Yamamoto

Iwamoto

Bessho

et al. 2013

Bull. Tokyo Dent. Coll.

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A schwannoma is a benign tumor composed of schwann cells which forms on the periphery of nerves. We report a case of a schwannoma derived from a lingual nerve occurring in the floor of the mouth. The patient was a 27-year-old woman who presented with the complaint of a swelling in the floor of the mouth. It is difficult to distinguish a swelling from a sublingual gland tumor, cyst, or malignant tumor by MRI alone. Therefore, a biopsy and cytological examination were performed one week prior to surgery to determine whether the growth represented a malignancy. The results revealed a class II growth which was suspected to be a schwannoma. Intraoperatively, it became clear that the tumor and lingual nerve were inseparable, making excision of the nerve unavoidable. On the other hand, there was a clear border between the tumor and the sublingual gland, so it was possible to preserve the sublingual gland. In the postoperative pathological diagnosis, a definitive diagnosis was difficult based solely on H-E staining. Therefore, immunohistochemical staining was performed, resulting in a diagnosis of schwannoma. Currently, the patient is still being followed up. The results of this case indicate that preoperative aspiration biopsy cytology is useful in deciding the operative method to be employed.

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Palatal ancient schwannoma: optical, immunohistochemical and ultrastructural study with literature review

Vera-Sirera

Fernades-Ciacha

Floría

et al. 2017

Eur Arch Otorhinolaryngol

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Schwannoma or neurilemmoma is a benign encapsulated slow-growing tumor that originates from a Schwann cell of a nerve, and is rare at intraoral locations. Different histological variants of schwannomas have been described, of these degenerative or ancient schwannoma is probably one of the least common in the oral cavity with only 16 previously reported cases, of which only one has been described in palatal location. Although ancient schwannoma shows particular characteristics, it is difficult to diagnose based on clinical and imaging appearance alone; as a result, morphological examination assisted by ancillary techniques is necessary to establish a definite diagnosis. We present a clinicopathological description of this rare variant of schwannoma, located in an unusual intraoral site, of a 26-year-old female. We illustrate the optical, immunohistochemical and ultrastructural characterization that aid diagnosis, as well as providing a review of the relevant published data of this unusual tumor.

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Ancient Schwannoma in the Buccal Region

Cited by 8 publications

References 8 publications

Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Schwannoma Derived from Lingual Nerve Occurring in Floor of Mouth

Palatal ancient schwannoma: optical, immunohistochemical and ultrastructural study with literature review

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