1
|
Maulana R, Pahlevi MR, Rosanto YB, Sejati BP, Hasan CY. A rare case of upper lip schwannoma: A case report with analysis of the histological, immunohistochemical and pathogenesis aspects. Int J Surg Case Rep 2024; 118:109445. [PMID: 38615463 PMCID: PMC11021950 DOI: 10.1016/j.ijscr.2024.109445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Schwannoma, a benign tumor originating from Schwann cells, is a rare case found intraorally. The tongue, palate and buccal mucosa are the most common sites of intraoral Schwannoma while it is very rarely found on the lips. Previous studies reported only twelve cases of Schwannoma on the upper lip. The etiology of Schwannoma is unknown, but in some literature, Schwannoma occurs due to a defect in the NF2 gene. Management of Schwannoma is excision of the capsule. The prognosis is good, and the recurrency is low. This article reports a rare case of upper lip Schwannoma in adolescent and its management with its histological, immunohistochemical and pathogenesis aspects. CASE PRESENTATION A 16-years old female presented a painless, semi-solid, mobile lump on the upper lip measuring of approximately 1.5 × 3 cm that had similar color with the surrounding tissue. The lump appeared 7 years ago. CLINICAL DISCUSSION Excision of the capsule and margins of the tumor. Histopathological examination showed a unique feature of Schwannoma, the Verocay bodies. Subsequent immunohistochemical examination of S100 protein showed a classic type of Schwannoma. CONCLUSION Upper lip schwannoma is a very rare tumor, and this type of tumor cannot be distinguished from other benign soft tissue tumors based on clinical findings. Immunohistochemical results are in accordance with the Histopathological results for the final diagnosis of Schwannoma. Schwannoma can be used as a differential diagnosis in cases of lumps on the lips with sessile, similar color like surrounding tissue, painless, and movable features.
Collapse
Affiliation(s)
- Rizqan Maulana
- Oral and Maxillofacial Surgery Study Program, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia
| | - Muhammad Reza Pahlevi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia
| | - Yosaphat Bayu Rosanto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia
| | - Bramasto Purbo Sejati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia
| | - Cahya Yustisia Hasan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia.
| |
Collapse
|
2
|
Hasan S, Ahmad SA, Kaur M, Panigrahi R, Panda S. Lymphangioma of the Lower Lip-A Diagnostic Dilemma: Report of a Rare Case with a Brief Literature Review. Case Rep Dent 2022; 2022:7890338. [PMID: 35692488 PMCID: PMC9184214 DOI: 10.1155/2022/7890338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Hamartomas are tumor-like deformities typified by cellular propagation indigenous to the original site, although they display growth arrest without the possibility for further growth. Various hamartomatous oral lesions include hemangiomas, lymphangiomas, nevi, odontomas, Cherubism, etc. Lymphangiomas are benign, developmental hamartomatous entities typified by abnormal proliferation of lymphatic vessels. They are usually congenital, and more than 90% of cases occur by 2 years of age, with a rare occurrence in adults. They have a site affinity for the head and neck, and oral lesions are relatively uncommon. The dorsum of the tongue is the commonest oral site of predilection; however, the lip is a rare site of involvement. Hereby, we present an uncommon case of lymphangioma of the lower lip in a 45-year-old male patient, who reported to our hospital with an asymptomatic lower lip submucosal mass present for the last 3 years. Our case is unique as it occurred on the lower lip of a 45-year-old male. A detailed history and clinical evaluation, ultrasonography, and histopathology confirmed the diagnosis of lymphangioma.
Collapse
Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Syed Ansar Ahmad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mandeep Kaur
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O' Anusandhan University, Bhubaneswar, Odisha, India
| | - Swagatika Panda
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha ‘O' Anusandhan University, Bhubaneswar, Odisha, India
| |
Collapse
|
3
|
Bakir M, Enabi J, Almeshal H. Unusual Lower Lip Swelling: A Rare Case of Lip Schwannoma. Cureus 2021; 13:e19242. [PMID: 34900449 PMCID: PMC8647776 DOI: 10.7759/cureus.19242] [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] [Accepted: 11/03/2021] [Indexed: 11/08/2022] Open
Abstract
Schwannoma (neurilemmoma) is a benign neoplasm that arises from the nerve sheath's Schwann cells. Between 25% and 40% of all schwannomas are discovered in the soft tissues of the head and neck area, but they are infrequently detected in the oral cavity, with the lips being the most unusual site of involvement. Peripheral nerves in the intraoral cavity originate only 1% of schwannomas despite the fact that lips and oral cavity are heavily innervated anatomical areas. Schwannomas are more common in people between the third and fifth decades of life, and there is no predilection based on gender or race. Here, we report a case of lip schwannomas in a 22-year-old female. The lesion was affecting her lower lip and growing steadily for the past two years. The mass measured 1.5 x 1 cm, involving the lower lip with surface telangiectasia. The patient underwent surgical removal of the lower lip mass, and the mass was sent for histopathological correlation that showed completely excised encapsulated schwannoma with free margins. The patient did not have any postoperative complications and was discharged home on the same day. The patient was followed up in the outpatient clinics, and she made full recovery and was pleased with the outcome.
Collapse
Affiliation(s)
- Mohamad Bakir
- Medicine and Surgery, College of Medicine, Alfaisal University, Riyadh, SAU
| | - Joud Enabi
- Medicine and Surgery, College of Medicine, Alfaisal University, Riyadh, SAU
| | - Hanan Almeshal
- Department of Dermatology, Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, SAU
| |
Collapse
|
4
|
Panico R, Panico I, Leonardi N, Garola F, Gilligan G. An unexpected finding in a labial swelling. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:259-263. [PMID: 34511350 DOI: 10.1016/j.oooo.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/23/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- René Panico
- Head Professor, Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina
| | - Ignacio Panico
- Dentistry School, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina
| | - Nicolás Leonardi
- Assistant Professor, Oral Medicine Department, Dentistry School, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina
| | - Federico Garola
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina
| | - Gerardo Gilligan
- Assistant Professor, Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina.
| |
Collapse
|
5
|
Alhammad G, Alsaad A, Aljohani T, Alajlan A. Schwannoma of the Lower Lip: A Case Report of an Unusual Presentation. Case Rep Dermatol 2021; 13:164-170. [PMID: 33790761 PMCID: PMC7989678 DOI: 10.1159/000513568] [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: 11/04/2020] [Accepted: 12/03/2020] [Indexed: 11/19/2022] Open
Abstract
Schwannoma is a benign neoplasm that originates from the neural sheath of Schwann cells. Although extracranial schwannomas are commonly observed in the head and neck region, only 1% are found in the intraoral cavity. This article describes the first case in the Eastern Mediterranean region of a lower lip schwannoma in a 17-year-old male patient.
Collapse
Affiliation(s)
- Ghadah Alhammad
- Dermatology Department, College of Medicine and University Hospitals, King Saud University, Riyadh, Saudi Arabia
| | - Alaa Alsaad
- Dermatology Department, College of Medicine and University Hospitals, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Aljohani
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulmajeed Alajlan
- Dermatology Department, College of Medicine and University Hospitals, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
6
|
Comprehensive Analyses of Intraoral Benign and Malignant Nerve Sheath Tumors: The Rare Disease Entities Revisited. J Craniofac Surg 2019; 30:e317-e327. [PMID: 30845091 DOI: 10.1097/scs.0000000000005231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
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.
Collapse
|
7
|
Yaghoobi R, Pazyar N. Lower Lip Plexiform Schwannoma: Report of a Rare Case and a Literature Review. Indian J Dermatol 2019; 64:407-410. [PMID: 31543538 PMCID: PMC6749764 DOI: 10.4103/ijd.ijd_207_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Plexiform schwannoma is an uncommon benign neoplasm of the neural sheath characterized grossly and microscopically by multinodular growth. It is typically presented as a mobile, solitary, smooth-surfaced, and nontender mass. Histologically, schwannomas are classified into the following seven types: classical (Verocay), plexiform, cellular, cranial nerve, melanotic, degenerated (ancient), and granular cell schwannomas. In spite of the fact that plexiform schwannoma commonly occurs in the head-and-neck region, the involvement of the lip is considered to be extremely rare. Herein, we present the case of a 16-year-old boy with the schwannoma on the lower lip excised without any recurrence at 9 months after surgery.
Collapse
Affiliation(s)
- Reza Yaghoobi
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Pazyar
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
8
|
Sitenga J, Aird G, Vaudreuil A, Huerter CJ. Clinical features and management of schwannoma affecting the upper and lower lips. Int J Dermatol 2018; 57:1047-1052. [PMID: 29377087 DOI: 10.1111/ijd.13920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/21/2017] [Accepted: 01/01/2018] [Indexed: 11/30/2022]
Abstract
Head and neck schwannomas comprise 25-40% of all schwannomas, with presentation on the lips as the rarest and most surgically complicated site for perioral tumors. A systematic literature review was conducted to include 21 cases of patients with schwannoma of the upper or lower lips. The majority of patients presented with a single, painless, well-encapsulated nodule on the upper or lower lips. The nodules were consistently slow-growing, with an average 29.3 months from symptom onset to clinical presentation. Most cases were complicated by profound cosmetic disfigurement as well as dysphagia, dysarthria, snoring, and/or sleep apnea. Overall, histological analysis was consistent with classic schwannoma, and all cases were treated via complete surgical excision, and for malignant tumors, additional therapy was utilized. All but four cases achieved full remission by final follow-up. Recurrence rate for benign lip schwannomas was 5.3%, which is remarkably different from the standard recurrence rate of 8-24% for benign peripheral schwannomas. Additionally, the proportion of malignant tumors was greater for lip schwannomas than other schwannomas. Lip schwannomas demonstrate different characteristics than schwannomas from other locations on the body, and these remarkable differences highlight significant implications for clinical practice. Complete excision is the primary mode of treatment with overall excellent postoperative prognosis and rare instances of recurrence. Given the rarity of this tumor, this review of available cases serves to comprehensively describe clinical presentation and surgical treatment approaches to upper and lower lip schwannomas.
Collapse
Affiliation(s)
- Jenna Sitenga
- Creighton University School of Medicine, Omaha, NE, USA
| | - Gregory Aird
- Creighton University School of Medicine, Omaha, NE, USA
| | - Adam Vaudreuil
- Division of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| | | |
Collapse
|