Schwannoma-like pleomorphic adenoma of the parotid

Tille, Jean-Christophe; Reychler, Hervé; Hamoir, Marc; Schmitz, Sandra; Weynand, Birgit

doi:10.4081/rt.2011.e40

Cited by 9 publications

(15 citation statements)

References 17 publications

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“…The tumor of the deep lobe (case 1) was removed with a subtotal parotidectomy and case 2 was treated with a partial parotidectomy [4]. The tumor of the deep lobe with parapharyngeal extension was treated with a total parotidectomy [7]. The tumor in our case was removed with a superficial parotidectomy.…”

Section: Discussionmentioning

confidence: 79%

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Divergent Schwannoma-Like Phenotype in a Pleomorphic Adenoma

Chandra

Karim

Rawal

2017

Head and Neck Pathol

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The schwannoma-like pleomorphic adenoma is a rare histopathological variant of the pleomorphic adenoma. Five previous reports with seven cases exist in English language literature. These tumors present in the parotid gland most commonly. Intraparotid schwannomas of the facial nerve and schwannomas with glandular differentiation have also been reported. A 60-year-old male presented with an asymptomatic swelling over the left angle of the mandible. The swelling had been present for about 12 years with a recent increase in size. CT imaging showed a hyperdense circumscribed mass of the superficial lobe of the parotid. The working diagnosis was that of a benign tumor of salivary gland or soft tissue origin. The mass was excised with careful preservation of the facial nerve. The 3.5 cm mass was submitted for histopathological examination. The well-circumscribed, encapsulated mass showed a predominant sheet-like proliferation of Antoni type A-like tissue, Foci of glandular differentiation with duct-like structures were also seen. Cytological atypia or mitotic activity were not seen. Nuclei of lesional cells diffusely and strongly expressed reactivity to p63. The final diagnosis was a schwannoma-like pleomorphic adenoma. No recurrence has been reported in the 15 months since the removal. Facial nerve function is unimpaired with a House Brackmann facial nerve function score of one. The potential for misdiagnosis in fine needle aspirate and incisional biopsies is real in cases of schwannoma-like pleomorphic adenoma. The diagnostic pitfalls include the schwannoma and leiomyoma. Schwannomas with glandular differentiation have also been reported and therefore a misdiagnosis may potentially occur in excised specimens. Careful application of immunohistochemistry may help in the differentiation of these lesions.

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Section: Discussionmentioning

confidence: 79%

“…The patient with the deep lobe tumor with extension into the parapharyngeal space had pain of 2 months duration. It is likely that that this 3.2 cm tumor was present for a significantly longer period of time [7]. Five other cases were asymptomatic.…”

Section: Discussionmentioning

confidence: 90%

Divergent Schwannoma-Like Phenotype in a Pleomorphic Adenoma

Chandra

Karim

Rawal

2017

Head and Neck Pathol

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“…Five of the cases were described in females and one in a male with age ranging from 39 to 75 years (mean age 57.5 years). The lesions were mostly localized in the parotid gland (five cases), with the exception of a unique case that was localized in the hard palate [3][4][5][6]. The diameter of the lesions varied from 1.5 to 3.5 cm (mean value 2.6 cm).…”

Section: Discussionmentioning

confidence: 97%

“…In this report we present a rare case of pleomorphic adenoma with extensive schwannoma-like features representing almost the entire lesion. Schwannoma-like pleomorphic adenomas are composed of modified myoepithelial cells expressing p63, CD10 and pan-cytokeratin by immunohistochemistry [4,5].…”

Section: Discussionmentioning

confidence: 99%

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Schwannoma-Like Pleomorphic Adenoma: A Case Report with Review of the Literature

Lombardi

Socciarelli

Fini

et al. 2013

Head and Neck Pathol

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Pleomorphic adenoma is a common benign salivary gland tumor, which represents about 66 % of benign neoplasms of the salivary glands. Although it can occur in any salivary gland, it is most frequently found in the parotid. Pleomorphic adenomas are renowned for their cytomorphological and architectural heterogeneity that are characterized by intermixed epithelial and mesenchymal-like components. We report a rare case of pleomorphic adenoma of the parotid gland with prevalent schwannoma-like features mimicking a benign schwannoma. Microscopically the tumor showed a prevalence (about 95 %) of schwannoma-like areas with focal (about 5 %) epithelial component with tubular organization. The tumor showed positive immunoexpression for cytokeratin, S-100 protein, and focal expression of p63, CD10 and smooth muscle actin. To the best of our knowledge only six cases of schwannoma-like pleomorphic adenoma have been reported in the literature. The differential diagnosis between this entity and neurogenic and myogenic tumors is discussed.

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