Palatal schwannoma in an elderly woman

Schwannoma in Soft Palate: A Rare Case Report with Review of Literature

Schwannoma is a benign tumor originating from Schwann cells of the nerve sheath. Approximately 25-45% of the schwannomas are seen in the head and neck region and are found rarely in the oral cavity (only 1%). The most common intra-oral site is tongue, followed by floor of the mouth, buccal mucosa, palate, gingiva and lips. We report a rare case of schwannoma in the soft palate in a 22 years old female. She presented with 6 months history of a painless swelling in palate. The provisional diagnosis was made as some benign neoplasm of minor salivary gland. The tumour was excised intra-orally under general anesthesia. Histopathologic examination showed neural tissue arranged in predominantly Antoni A pattern and formation of verocay bodies. It is difficult to diagnose this tumor based on clinical appearance. Therefore final diagnosis can only be done after histopathological examination of the lesion. Prognosis is good and recurrence is unknown.

Palatal Schwannoma: An Analysis of 45 Literature Reports and of an Illustrative Case

Introduction  Schwannomas are benign tumors originating from differentiated Schwann cells. Being the least common intraoral neoplasm of neural origin, it is rarely seen in the palate. The literature lacks an extensive review of intraoral schwannoma confined to the palate.

Objective  To review previously reported cases of palatal schwannoma along with an illustrative case, and to provide a better insight regarding clinicopathological and radiological features of this neural tumor in a rare intraoral site.

Data Synthesis  We present a case of palatal schwannoma in a 16-year-old female. An additional 45 cases were identified in 2 medical database searches (PubMed and Google Scholar) published from the year 1985 onwards, and from 13 countries, in the 5 continents. The ages of the patients ranged from 3 to 84 years old. Palatal schwannoma showed a slight predilection to females, with a male/female ratio of ∼ 1:1.81. Hard palate involvement is almost twice greater than soft palate involvement. Surgical excision was employed in almost all of the cases, and recurrence was reported only once.

Conclusion  Palatal schwannomas, although rare, have been reported both over the hard and the soft palate. They mostly present as a painless, firm, well-encapsulated, slow-growing solitary lesion over the lateral palatal aspect.

Imaging can add to suspicion and can delineate a differential diagnosis, but the diagnosis is confirmed by pathological examination. Fine-needle aspiration cytology (FNAC) is almost always inconclusive. Immunohistochemistry can assist in confirming a diagnosis, but is more important to rule out close differentials. Complete surgical excision is the treatment of choice, and recurrence or malignant transformation are extremely rare.

Comprehensive Analyses of Intraoral Benign and Malignant Nerve Sheath Tumors: The Rare Disease Entities Revisited

INTRODUCTION

Intraoral benign and malignant nerve sheath tumors (BNST and MNST) are rare tumors with non-specific clinical presentations and represent diagnostic and therapeutic challenges. Current knowledge regarding their demographic, clinicopathological features and treatments remains fragmented.

MATERIALS AND METHODS

The original data about patients diagnosed as intraoral BNST and MNST were retrieved from our disease registry (2005-2017). Comprehensive reviews of English and Chinese literature were performed to collect and analyze the epidemiological, clinicopathological data and treatment outcomes about those published cases.

RESULTS

Thirty-four intraoral BNSTs were found at our institution in the past 13 years. Literature reviews identified 354 intraoral BNSTs in 223 articles and 60 intraoral MNSTs in 50 articles. Most intraoral BNSTs and MNSTs were presented in the second to fifth decade of life. Males outnumbered females in MNSTs, while BNSTs displayed a slight female preponderance. The common sites for intraoral BNSTs were parapharyngeal space followed by tongue, whereas mandible was the most common site for MNSTs. Most intraoral BNSTs were presented as slow-growing, painless mass or swelling, while MNSTs usually appeared as painful and invasive mass with discomfort. Surgical excision was preferred for intraoral BNSTs with excellent prognosis. Complete resection was indicated for intraoral MNST with dismal prognosis as evidenced by much recurrence, metastasis, and death.

CONCLUSION

Intraoral BNST and MNST are rare diseases which should not be ignored when intraoral painless or painful mass/swelling is found. Surgical excision is indicated for intraoral BNST with favorable outcomes. However, further investigations are warranted to optimize the treatment for intraoral MNST to improve its prognosis.

Schwannoma in the midline of hard palate: a case report and review of literature

Schwannoma is a benign encapsulated slow-growing tumor that originates from Schwann cells of the peripheral nerve sheath. It usually occurs in the head and neck; however, it is rare in the oral cavity. The tongue is the most common site of intraoral schwannomas, followed by the floor of the mouth, palate, gingiva, vestibular mucosa, lips and mental nerve area. We report a rare case of schwannoma in the midline of hard palate with ulcerated surface in a 21-year-old male with a two-month history of a painless swelling on his palate. Clinical, radiographic and histopathological features along with differential diagnosis and treatment are also discussed.

Intraoral Schwannomas: Presentation of a series of 12 cases

Introduction: Schwannomas are benign and not very frequent tumors of the peripheral nerves, derived from the nerve supporting Schwann cells. Study Design: Data were collected on the clinical manifestations (sex, age), location, size and symptonts of the lesions as well as the evolution time and the initial (presumption) diagnosis. Results: Twelve patients were documented, with a mean age of 29,5 ± 12,1 years (range 16-50) and a balanced gender distribution. The mean duration of the lesions was 42,17± 45,3 months. The lesion located in the floor of the mouth was the largest tumor, measuring about 4 cm in maximum diameter, while the average size of the 12 schwannomas was 2.04± 1.1 cm. Conclusion: We present 12 oral schwannomas diagnosed and treated over a period of 10 years.

Key words:Schwannomas, oral benign tumor, neurilemmoma.