Sublingual Gland Schwannoma: A Rare Case at an Unusual Site

Schwannoma arising from the sublingual glandular branch of the lingual nerve radiologically masquerading as sublingual gland tumor

We report a rare case of schwannoma arising from the sublingual glandular branch of the lingual nerve radiologically masquerading as sublingual gland tumor. A 42-year-old female was referred to our department with a painless swelling in the left submandibular region. Contrast-enhanced computed tomography showed a well-circumscribed, heterogeneous low-density tumor with cystic change in the left sublingual region. Magnetic resonance imaging showed a well-circumscribed, heterogeneous sublingual tumor with low-signal intensity on T1-weighted image and high-signal intensity in T2-weighted image. The lesion was diagnosed radiologically as benign sublingual gland tumor. The patient underwent resection of sublingual gland tumor under general anesthesia. There was no definitive continuity between the tumor and the sublingual gland, and the tumor originated from sublingual glandular branch of the lingual nerve. Pathological examination of the specimen showed schwannoma with highly cellular areas (Antoni A) and hypocellular areas (Antoni B). The postoperative course was uneventful without lingual nerve palsy, and there was no recurrence 4 years after surgery.

Schwannoma of the tongue: a case report with review of literature

BACKGROUND

Schwannomas (or neurilemmomas) of the tongue are benign, usually solitary, encapsulated masses derived from Schwann cells. Clinical evidence indicates that schwannoma is painless and slow growing. In general, schwannoma is treated by surgical excision. Here, we describe a case of schwannoma of the tongue, include a review of the literature from 1955 to 2016, and provide data on age, gender, location, presenting symptoms, size, and treatment methods.

CASE PRESENTATION

A 71-year-old female patient presented with a swelling at the base of the tongue of unknown duration. Magnetic resonance images (MRI) showed a large well-circumscribed solid mass and no significant lymph node enlargement. The mass was excised without removing overlying mucosa.

CONCLUSIONS

The authors report a case of lingual schwannoma that was completely removed intraorally without preoperative biopsy. No sign or symptoms of recurrence were observed at 12 months postoperatively.

Neurilemmoma in the floor of the mouth: a case report

Neurilemmomas are well-encapsulated, benign, slow-growing tumors originating from Schwann cells of the nerve sheath surrounding cranial, peripheral, or autonomic nerves. Intraoral neurilemmomas are relatively rare and have a wide variety of morphologic and radiologic features. This makes differential diagnosis difficult, and only histopathological features can lead to a definitive neurilemmoma diagnosis. In this report, we present the case of a 30-year-old woman whose chief complaint was a solitary, nodular mass on the right floor of the mouth. After computed tomography and magnetic resonance imaging, we performed an incisional biopsy that showed the typical characteristics of a neurilemmoma. The mass was removed completely through an intraoral surgical approach. Despite losing a portion of the lingual nerve, the patient did not complain of any specific discomfort. Wound healing was uneventful and there were no signs or symptoms of recurrence.