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M Jahad N, Ridal M, Chafai H, Douida A, Naoual H, Akamar A, Maaroufi M, Alami MNE. Schwannoma of the descending loop of the hypoglossal nerve: case report. Pan Afr Med J 2020; 36:73. [PMID: 32774632 PMCID: PMC7386277 DOI: 10.11604/pamj.2020.36.73.23500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 12/04/2022] Open
Abstract
Schwannomas of the descending loop of the hypoglossal nerve are very rare. Existing literature of the schwannoma of the descending loop of the hypoglossal nerve is limited to two previously reported case. They are slow-growing tumors that may masquerade a carotid body tumor. We herein described a rare case of schwannoma of the descending loop of the hypoglossal nerve in the s right latero-cervical region with diagnostic imaging and histopathological findings. A 37-years-old woman has had a palpable firm, mobile mass in the right latero-cervical region, of imaging, MR images showed homogeneous hypointensity on T1-weighted imaging (T1-WI), heterogeneous hyperintensity on T2-WI, and heterogeneous enhancement on contrast-enhanced T1-WI. Diagnostic imaging using computed tomography (CT) and magnetic resonance imaging (MRI) was suspected of Chemodectoma or neurogenic tumor. At operation, a 4 cm mass arising from the descending loop of the hypoglossal nerve of was resected en bloc with the loop itself; Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings. Postoperative course was uneventful and the patient is free from disease recurrence at tree-year follow-up. En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, besides requiring reintervention, it may harbor a malignant evolution towards sarcoma. Schwannomas of the descending loop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.
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Affiliation(s)
- Nadia M Jahad
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Otorhinolaryngology (ENT) and Head - Neck Surgery, Hassan II University Hospital, Fez, Morocco
| | - Mohamed Ridal
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Otorhinolaryngology (ENT) and Head - Neck Surgery, Hassan II University Hospital, Fez, Morocco.,Faculty of Medicine and Pharmacy, "Anatomy, Surgery and Anesthesiology" laboratory Sidi Mohammed Benabdellah University, Fez, Morocco
| | - Houda Chafai
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Otorhinolaryngology (ENT) and Head - Neck Surgery, Hassan II University Hospital, Fez, Morocco
| | - Amal Douida
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Pathology, Hassan II University Hospital, Fez, Morocco
| | - Hammas Naoual
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Pathology, Hassan II University Hospital, Fez, Morocco
| | - Aamal Akamar
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Radiology, Hassan II University Hospital, Fez, Morocco
| | - Mustapha Maaroufi
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Radiology, Hassan II University Hospital, Fez, Morocco
| | - Mohamed Nourredine El Alami
- Faculty of Medicine and Pharmacy, Sidi Mohammed Benabdellah University, Fez, Morocco.,Department of Otorhinolaryngology (ENT) and Head - Neck Surgery, Hassan II University Hospital, Fez, Morocco.,Faculty of Medicine and Pharmacy, "Anatomy, Surgery and Anesthesiology" laboratory Sidi Mohammed Benabdellah University, Fez, Morocco
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Ai CJ, Jabar NA, Lan TH, Ramli R. Mandibular Canal Enlargement: Clinical and Radiological Characteristics. J Clin Imaging Sci 2017; 7:28. [PMID: 28781925 PMCID: PMC5523564 DOI: 10.4103/jcis.jcis_28_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/29/2017] [Indexed: 11/25/2022] Open
Abstract
Enlargement of the mandibular canal is a rare radiological finding. Clinically, it may or may not be associated with sensory deficits. We report four cases of widening of the mandibular canal observed with various methods of imaging with different clinical characteristics. We describe this unique radiological finding and elaborate the importance of quality assessment of the imaging that is vital for accurate diagnosis and treatment planning. Clinicians should be mindful when assessing the imaging whenever the size of the mandibular canal is implicated. The case ranged from a benign tumor to malignancy, radiological errors, and artifacts. A more superior imaging or treatment modality was necessary to ascertain the diagnosis.
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Affiliation(s)
- Chong Jun Ai
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Nazimi Abd Jabar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Tan Huann Lan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Roszalina Ramli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, UKM and UKM Medical Centre, Kuala Lumpur, Malaysia
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Fornaro R, Salerno A, Filip DC, Caratto E, Caratto M, Casaccia M. Schwannoma of the hypoglossal nerve: Review of the literature based on an illustrative case. Mol Clin Oncol 2017; 7:288-294. [PMID: 28781804 DOI: 10.3892/mco.2017.1297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/16/2017] [Indexed: 12/12/2022] Open
Abstract
Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They are characterised by a slow growth tendency. Benign schwannomas represent 35% of the head and neck district tumours. Hypoglossal schwannomas account for 5% of non-vestibular schwannomas, and malignant schwannomas occur very rarely. In the present case report, the case of a 49-year-old man who presented with paraesthesias in the left parotid and submandibular region, associated with sensation of foreign bodies and dysphagia for solids, is described. A clinical examination revealed the presence of an ovoid palpable mass in the lateral-cervical region of the neck. The patient subsequently underwent excisional surgery, and neuropathological evaluation of the specimen confirmed the diagnosis of benign schwannoma with Antoni areas A and B. Despite the rarity of schwannomas, this condition should be considered in differential diagnoses for masses localised in the neck, as in cases where they reach considerable sizes (>3 cm in diameter). Surgery therefore represents the first-choice treatment.
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Affiliation(s)
- Rosario Fornaro
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
| | - Alexander Salerno
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
| | - David Constantin Filip
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
| | - Elisa Caratto
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
| | - Michela Caratto
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
| | - Marco Casaccia
- Department of Surgery, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, I-16132 Genoa, Italy
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Illuminati G, Pizzardi G, Pasqua R, Palumbo P, Vietri F. Schwannoma of the descending loop of the hypoglossal nerve: Case report. Int J Surg Case Rep 2017; 34:20-22. [PMID: 28324801 PMCID: PMC5358956 DOI: 10.1016/j.ijscr.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 02/27/2017] [Accepted: 03/04/2017] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Schwannomas of the descending loop of the hypoglossal nerve are very rare. They are slow-growing tumors that may masquerade a carotid body tumor. PRESENTATION OF CASE A 60-year-old female was referred for a latero-cervical mass appearing as a chemodectoma at CT-scan. At operation, a 2cm mass arising from the descending loop of the hypoglossal nerve was resected en bloc with the loop itself and a functional lymphadenectomy was associated. Post-operative course was uneventful and the patient is free from disease recurrence at one year follow-up. DISCUSSION En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, beside requiring reintervention, it may harbor a malignant evolution towards sarcoma. CONCLUSION Schwannomas of the descending lop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment.
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Affiliation(s)
- Giulio Illuminati
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy.
| | - Giulia Pizzardi
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Rocco Pasqua
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Piergaspare Palumbo
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - Francesco Vietri
- The Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
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