Infraorbital Nerve Schwannoma Presenting as an Upper Lip Mass in an Adolescent Boy

Kok, Yee Onn; Yeo, Matthew Sze‐Wei; Nallathamby, Vigneswaran; Lee, Shu Jin

doi:10.1097/sap.0b013e318248b8a2

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…This case showed gradual increase in size and was otherwise asymptomatic. Frequency of lip lesions is comparatively less [8].Infraorbital nerve schwannomas can present as lip masses [10]. Rarely, multinodular neurilemmomas are also seen [11].…”

Section: Discussionmentioning

confidence: 99%

Schwannoma of the upper lip: A case report and literature review

et al. 2017

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Introduction Schwannomas or neurilemmomas are well demarcated, benign neurogenic lesions arising by a fibroblastic proliferation of the nerve sheath cell (Schwann cell). They usually present as solitary encapsulated lesions with rare occurrence in the upper lip. Non-diagnosed or misdiagnosed schwannomas present a high risk for the tumor to continue growing and exerting pressure on surrounding nerves. These tumours based on their location could lead to facial weakness and paralysis, pressure in ears, tinnitus, hearing loss, balance loss, and could lead to a life-threatening situation. Case Outline This case is a rare presentation of a schwannoma located in the upper lip of a 21-year-old male patient of Indian origin. The patient complained of a swelling in the mouth with a difficulty in keeping the mouth closed. The swelling was surgically excised and the patient healed completely. Conclusion This case of occurrence of tumor on the upper lip points to the possibility of considering schwannoma as a possibility in the diagnosis of oral tumors in the future, as the location of the tumor was rare and had a high chance of misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Schwannoma of the upper lip: A case report and literature review

et al. 2017

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“…To best of our knowledge, only nine cases of infra-orbital schwannoma has been previously described in English literature. [ 3 7 8 9 10 11 12 13 14 ]…”

Section: Discussionmentioning

confidence: 99%

“…Schwannoma generally presents as slow growing painless sub-cutaneous or submucosal swelling. Depending on the site of nerve trunk or branch from which it arises, it may be located within the lower part of orbit,[ 7 8 9 ] maxillary sinus[ 3 ] or present as sub-cutaneous mass in infra-orbital region[ 10 11 12 ] [ Table 1 ]. Intraorbital schwannoma generally develop from supraorbital or supratrochlear nerves, and less frequently from infra-orbital nerves.…”

Section: Discussionmentioning

confidence: 99%

“…Incision placed in the natural skin crease of naso-labial fold was used to approach and completely remove the lesion. Other approaches used include intra-oral vestibular incision for smaller lesions localized in the buccal space,[ 10 11 14 ] Caldwell-Luc approach for tumor within the maxillary sinus,[ 3 ] Subcilliary or eyelid crease incision for intraorbital schwannoma. [ 8 9 ] Larger lesion involving greater areas of mid-face are treated by extra-oral Weber-Furgusson incision combined with ostectomy[ 13 ] [ Table 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Infra-orbital nerve schwannoma: Report and review

Kumar

2015

J Nat Sc Biol Med

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Extra-cranial schwannomas although common in head and neck region are very rarely seen originating from the infra-orbital nerve. We report a case of schwannoma arising from infra-orbital nerve in a 40-year-old male patient. The case presented as an isolated, asymptomatic, slow growing sub-cutaneous nodular swelling over left side of mid-face. On ultrasonography, a localized lesion within the sub-cutaneous tissue of cheek was observed, without involvement of orbital, maxillary sinus or underlying bone. Aspiration biopsy of the lesion showed spindle shaped cells predominantly arranged in Antoni A pattern around verocay bodies, with less organized Antoni B tissue in few places. Diagnosis of schwannoma, probably arising from terminal branch of infra-orbital nerve was established. The tumor was approached through skin incision. At the time of exploration, the lesion was found to emanate from the nerve trunk of peripheral branch of infra-orbital nerve, which was dissected and preserved. We correlate our experience with previously reported cases of infra-orbital nerve schwannoma.

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“…Although schwannomas represent benign peripheral tumors, the histology of larger lip schwannomas can often be misleading, causing a false diagnosis of malignancy and unnecessary emotional distress for the patient . Depending on the size and exact location of the lesion, surgical resection of schwannomas located on the lips is inherently difficult due to intricate neuronal anatomy within the extensive neuronal innervation of the lips . The high degree of neural innervation requires exact precision during surgery and even slight damage during excision may cause significant morbidity such as impaired speech, aspiration, dysarthria, dysphagia, and paresthesia .…”

Section: Introductionmentioning

confidence: 99%

Clinical features and management of schwannoma affecting the upper and lower lips

et al. 2018

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Head and neck schwannomas comprise 25-40% of all schwannomas, with presentation on the lips as the rarest and most surgically complicated site for perioral tumors. A systematic literature review was conducted to include 21 cases of patients with schwannoma of the upper or lower lips. The majority of patients presented with a single, painless, well-encapsulated nodule on the upper or lower lips. The nodules were consistently slow-growing, with an average 29.3 months from symptom onset to clinical presentation. Most cases were complicated by profound cosmetic disfigurement as well as dysphagia, dysarthria, snoring, and/or sleep apnea. Overall, histological analysis was consistent with classic schwannoma, and all cases were treated via complete surgical excision, and for malignant tumors, additional therapy was utilized. All but four cases achieved full remission by final follow-up. Recurrence rate for benign lip schwannomas was 5.3%, which is remarkably different from the standard recurrence rate of 8-24% for benign peripheral schwannomas. Additionally, the proportion of malignant tumors was greater for lip schwannomas than other schwannomas. Lip schwannomas demonstrate different characteristics than schwannomas from other locations on the body, and these remarkable differences highlight significant implications for clinical practice. Complete excision is the primary mode of treatment with overall excellent postoperative prognosis and rare instances of recurrence. Given the rarity of this tumor, this review of available cases serves to comprehensively describe clinical presentation and surgical treatment approaches to upper and lower lip schwannomas.

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Infraorbital Nerve Schwannoma Presenting as an Upper Lip Mass in an Adolescent Boy

Cited by 11 publications

References 6 publications

Schwannoma of the upper lip: A case report and literature review

Schwannoma of the upper lip: A case report and literature review

Infra-orbital nerve schwannoma: Report and review

Clinical features and management of schwannoma affecting the upper and lower lips

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