Schwannoma of the submandibular gland: a case report

Abstract

IntroductionSchwannoma is a benign, solitary, and slowly progressive encapsulated tumor originating from the sheath of myelinated nerve fibers. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor. Here, we present an unusual case of a schwannoma of the submandibular gland in a 19-year-old man. Total excision of the submandibular gland resulted in complete resolution of symptoms with no cranial nerve deficits. The details of the histopathologic and immunohistochemical features are presented.Case presentationA 19-year-old Caucasian man was admitted to our clinic with a painless mass on the right side of his neck that he had had for the past four months. A neck examination revealed a smooth-surfaced, mobile, firm, and painless mass, 6cm in its greatest diameter, on the right side of the submandibular region. Fine-needle aspiration cytology was suggestive of a submandibular gland schwannoma. After the initial evaluation, our patient was prepared for surgical evaluation and resection with a presumptive diagnosis of a neurogenic tumor of the submandibular gland. The final diagnosis of schwannoma was verified by microscopic and immunohistochemical studies. At one-year follow-up of the case, there was no evidence of recurrence.ConclusionsSchwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor. Our findings indicate good prognosis in an unusual case of a submandibular gland schwannoma in a 19-year-old man treated by surgical excision with no recurrence within 12 months of follow-up.

A Case of Schwannoma of the Submandibular Region

“…The MRI appearances of the present case are identical to those in the previous reports [ 1 - 5 , 9 - 11 ]. Schwannomas show low to intermediate signal intensity on non-enhanced T1-WI and strong enhancement with or without enhancing cystic spaces on contrast-enhanced T1-WI.…”

“…Plain radiographs are not useful for establishing a diagnosis of schwannoma. Ultrasound examination reveals a well-circumscribed and heterogeneous mass [ 9 ]. On CT, schwannomas demonstrate low to intermediate attenuation on non-enhanced CT and variable enhancement on contrast-enhanced CT.…”

“…The parent nerve is eccentric to the nerve, and the mass demonstrates split-fat, fascicular and target signs [ 12 ]. The target sign is characterized by hypointensity at the center of the mass (fibrous component) and hyperintensity at the periphery (myxomatous component) on T2-WI [ 9 ]. Unfortunately, our case didn’t include these findings.…”

A Rare Schwannoma Of The Submandibular Gland: A Case Report

“…Although most schwannomas are known to be solitary, there is an association with neurofibromatosis type 2 .This is contrary with our patient, whoma well without any is known comorbids or any genetic disposition. Schwannomatosis is a well-established third form of neurofibromatosis, characterized by the presence of multiple non-vestibular, nonintradermal schwannomas, often associated with chronic pain 3 . Schwannomas are growing, solitary neoplasms of Schwann cell origin.…”

“…About 10-40% of extracranial schwannomas were not identified with the nerve origin 1,2,3 . Although schwannomas can arise from any nerve in the body, the most common locations include the head and neck area, contributed nearly 45% 3 . Schwannomas of the submandibular gland are rare causes of extracranial neurogenic tumours 4 .…”