Intraparotid Facial Nerve Schwannoma Mimicking Primary Parotid Neoplasm

Bewley, Arnaud F.; Azhdam, Ariel M.; Borrelli, Michela

doi:10.1177/01455613211040372

Cited by 6 publications

(11 citation statements)

References 6 publications

(9 reference statements)

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“…Like SFT, PG schwannoma also has been confused with PA by multiple authors using FNA. 30,32,[42][43][44] This is not completely surprising because PA with schwannoma-like features has been described in histologic sections. 45,46 Although IHC is extremely helpful, Chandra et al 46 caution against the sole reliance of S-100 stain in this situation because the myoepithelial cells of PA also express S-100.…”

Section: Discussionmentioning

confidence: 92%

“…In a literature review of 80 PG schwannomas, Bartindale et al 41 report that only 32% (6 of 19) of patients with preoperative FNAs were correctly diagnosed. Like SFT, PG schwannoma also has been confused with PA by multiple authors using FNA 30,32,42‐44 . This is not completely surprising because PA with schwannoma‐like features has been described in histologic sections 45,46 .…”

Section: Discussionmentioning

confidence: 99%

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Mesenchymal neoplasms of the parotid gland and parapharyngeal space: an FNA cytologic study of 22 nonlipomatous tumors

Wakely

2022

Cancer Cytopathology

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BACKGROUND Mesenchymal neoplasms of the parotid gland (PG) and para‐pharyngeal (PP) space are distinctly uncommon. Fine‐needle aspiration (FNA) biopsy experience with nonlipomatous neoplasms from this site is reviewed. METHODS Cytopathology and surgical pathology files were examined for mesenchymal PG and PP space neoplasms. FNA biopsy was performed using standard technique. RESULTS Twenty‐two PG and/or PP aspirates from 20 adults (male:female = 1.1:1; age range, 19‐84 years, mean age, 50 years) and a 10‐week‐old infant met inclusion criteria. Biopsy sites included PG (17, 77%) or PP space (5, 23%). Five of 6 malignant neoplasms (83%) were called malignant cytologically. Only 7 of 11 (63%) benign neoplasms were recognized as a benign neoplasm. None of 5 solitary fibrous tumor (SFT) cases were correctly recognized. Conversion to the Milan classification showed 8 (36%) FNA cases diagnosed as benign neoplasm, 6 (27%) malignant neoplasm, 4 (18%) neoplasm of uncertain malignant potential, 2 (9%) nondiagnostic, and single cases of suspicious for malignancy and nonneoplastic. There was 1 false‐positive and no false‐negative FNA diagnoses. Ancillary testing in 10 (45%) aspirates helped substantiate a correct specific diagnosis in 3 malignant and 3 benign cases. CONCLUSIONS FNA biopsy of nonlipomatous mesenchymal SG neoplasms is particularly challenging. Less than half (9 of 11, 41%) had specific FNA diagnoses that correctly matched the tissue diagnoses or clinical outcome. Accurate Milan categorization was superior for malignant neoplasms (5 of 6, 83%) in contrast to benign neoplasms (7 of 11, 63%), or neoplasms of uncertain malignant potential (SFT) (2 of 5, 40%).;

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Mesenchymal neoplasms of the parotid gland and parapharyngeal space: an FNA cytologic study of 22 nonlipomatous tumors

Wakely

2022

Cancer Cytopathology

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“…Multiple case reports exist of schwannoma being mistaken as a salivary gland tumor (usually pleomorphic adenoma) and vice versa using FNA. 6,16,28,31,32 In fact, schwannoma-like histopathology has been reported in resected examples of pleomorphic adenoma. [33][34][35] Another potential diagnostic pitfall is the cytologic atypia induced by degenerative (so-called "ancient") change in schwannoma.…”

Section: Discussionmentioning

confidence: 99%

“…This is not an uncommon error for examples of schwannoma arising within or adjacent to the major salivary glands. Multiple case reports exist of schwannoma being mistaken as a salivary gland tumor (usually pleomorphic adenoma) and vice versa using FNA 6,16,28,31,32 . In fact, schwannoma‐like histopathology has been reported in resected examples of pleomorphic adenoma 33–35 .…”

Section: Discussionmentioning

confidence: 99%

Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

Wakely

2023

Cancer Cytopathology

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Introduction Benign peripheral nerve tumors (BPNTs) are a heterogenous group of soft tissue tumors that include a variety of nerve sheath tumors, granular cell tumor (GCT), and ganglioneuroma. Only a few large studies exist on cytopathology and diagnostic accuracy using fine‐needle aspiration (FNA) biopsy for this set of neoplasms. Materials and methods Both surgical and cytopathology files were searched for cases of BPNT. FNA biopsy was performed using standard techniques. Results Eighty‐nine cases from 88 patients (male:female = 1:1; age range: 16–85 years, mean age, 51 years) met inclusion criteria. FNA sites included extremities (58, 65%), head/neck (14, 16%), deep (9, 10%), and trunk (8, 10%). Aspirates were from primary neoplasms in all but one instance. There were 65 schwannomas, seven neurofibromas, seven perineuriomas, seven GCTs, and three ganglioneuromas/neuromas. Aspirates of schwannoma, GCT, neurofibroma (NF), and perineurioma (PN) were correctly diagnosed in 86%, 100%, 29%, and 0% of cases, respectively. Five tumors (6%) were interpreted as either a specific sarcoma or suspicious for sarcoma. Remaining aspirates were classified as spindle cell neoplasm, salivary gland neoplasm, and nondiagnostic. Cytologic features for schwannoma, NF, PN, and ganglioneuroma showed spindle cell–dominant smears arranged mainly in syncytial clusters. GCT aspirates contained a population of epithelioid cells harboring coarsely granular cytoplasm and bare nuclei. Immunohistochemical (IHC) staining in 55 (62%) cases showed S‐100 expression in 95%. Conclusion FNA biopsy coupled with IHC is reliable in correctly classifying schwannoma and GCT, but less so for NF. Perineurioma can be mistaken for sarcoma.

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“…However, consideration should be given to the possibility of a tumor originating from structures in the same region, such as a tumor arising from the facial nerve [1]. To differentiate between the various potential aetiologies, imaging, fine needle aspiration cytology (FNAC), core needle biopsy, and intraoperative frozen section are required.…”

Section: Introductionmentioning

confidence: 99%

A Benign Parotid Tumour Masquerading as A Schwannoma: A Case Report and Literature Survey.

2022

J Med Case Rep Case Ser

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Intraparotid Facial Nerve Schwannoma Mimicking Primary Parotid Neoplasm

Cited by 6 publications

References 6 publications

Mesenchymal neoplasms of the parotid gland and parapharyngeal space: an FNA cytologic study of 22 nonlipomatous tumors

Mesenchymal neoplasms of the parotid gland and parapharyngeal space: an FNA cytologic study of 22 nonlipomatous tumors

Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

A Benign Parotid Tumour Masquerading as A Schwannoma: A Case Report and Literature Survey.

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