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Zhang X, Gao Q, Xuan Y. Maxillary gingival neurolemmoma: a case report and literature review. BMC Oral Health 2023; 23:770. [PMID: 37858072 PMCID: PMC10588195 DOI: 10.1186/s12903-023-03509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/08/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE To explore and summarize the clinical features, differential diagnosis and treatment of the oral maxillofacial schwandoma. CASE PRESENTATION This is a report of a case of a 46-year-old female patients with neurolemmoma in the maxillary gingiva. The clinical features, pathological features, differential diagnosis and treatment were analyzed. Literature review was conducted in search of domestic and overseas journal full-text database from 1986 ~ 2017. 39 reports on the oral and maxillofacial Neurolemmoma from 1986 to 2017 in the database of China hospital knowledge database and the PubMed database, there were 405 patients. There were 23 cases of gingival mucosa, 17 in foreign literature and only 6 in the domestic literature. CONCLUSIONS The incidence of gingival Neurolemmoma is extremely low, the predilection age is similar to other parts, it is middle-aged and young, and there is no obvious gender tendency. About 25-45% of schwannomas are found in the head and neck, and rarely in the mouth (only 1%). The most common internal location of the mouth is the tongue, followed by the floor of the mouth, buccal mucosa, palate, gums, and lips. Schwannomas are slow-growing benign tumors that are rare in the gums. Gingival schwannoma is usually a single occurrence, and the clinical manifestations are mostly painless gum mass, tooth loosening and displacement, without peripheral bone changes and regional lymph node metastasis. It is difficult to diagnose this tumor according to clinical manifestations, and pathological diagnosis is still the basis for the diagnosis of gingival schwannoma. So far, surgical resection is the preferred treatment for this disease, and the prognosis is good.
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Affiliation(s)
- Xiangzi Zhang
- Yanbian University Medical College, JiLin, 133000, China
- Stomatology Department, Affiliated Hospital of Yanbian University, JiLin, 133000, China
| | - Qiming Gao
- Stomatology Department, Affiliated Hospital of Yanbian University, JiLin, 133000, China
| | - Yunze Xuan
- Stomatology Department, Affiliated Hospital of Yanbian University, JiLin, 133000, China.
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Das C, Dey K, Das SK. Schwannoma in Soft Palate: A Rare Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:2482-2485. [PMID: 36452788 PMCID: PMC9702478 DOI: 10.1007/s12070-020-02235-8] [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: 09/14/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022] Open
Abstract
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.
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Affiliation(s)
- Chiranjib Das
- Department of ENT, Coochbehar Government Medical College and Hospital, Cooch Behar, West Bengal India
| | - Kaushik Dey
- Metropolis Healthcare Pvt Ltd, Kolkata, West Bengal India
| | - Sudip Kumar Das
- Department of ENT, IPGMER and SSKM Hospital, Kolkata, West Bengal India
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Schuch LF, Kirschnick LB, de Arruda JAA, Klein IP, Silveira FM, Vasconcelos ACU, Santos-Silva AR, Lopes MA, Carrard VC, Vargas PA, Martins MAT, Wagner VP, Martins MD. Malignant peripheral nerve sheath tumour of the oral and maxillofacial region-A systematic review. Oral Dis 2021; 28:2072-2082. [PMID: 34333825 DOI: 10.1111/odi.13982] [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: 06/15/2021] [Revised: 07/05/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
To integrate the available data published on malignant peripheral nerve sheath tumours (MPNST) of the oral and maxillofacial region. Searches in Embase, PubMed, Web of Science and Scopus were conducted for the identification of case reports/case series in English language. The risk of bias was assessed using the Joanna Briggs Institute tool. Outcomes were evaluated by Cox regression and Kaplan-Meier methods. A total of 306 articles were retrieved, 50 of which reporting 57 MPNST were included. The lesion showed a predilection for the mandible (n = 18/31.57%) of middle-aged adults (~40.5 years) with a male/female ratio of 1.1:1. The individuals were mostly symptomatic with a mean evolution time of 9.6 months. Surgical removal plus adjuvant therapy (especially radiotherapy) was the main approach (51.86%). Recurrence was reported in 39.62% of cases. Nodal and distant metastases were identified in 28.26% and 26.66% of cases, respectively. The 2-year cumulative survival rate was 55%. Independent predictors of poor survival were the presence of neurofibromatosis type 1 (p = 0.04) and distant metastases (p = 0.004). The diagnosis of MPNST is challenging due to the variety of its clinical and histopathological presentations. Local aggressiveness and the potential for metastases are common outcomes of this neoplasm.
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Affiliation(s)
- Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Laura Borges Kirschnick
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isadora Peres Klein
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Martins Silveira
- Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | | | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul; Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul; Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil.,Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Araujo JP, de Oliveira JX, Lanel V, Marcucci M. Neurofibrosarcoma of the mandible derived from neurofibromatosis. AUTOPSY AND CASE REPORTS 2019; 9:e2019094. [PMID: 31641652 PMCID: PMC6771446 DOI: 10.4322/acr.2019.094] [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: 02/06/2019] [Accepted: 04/08/2019] [Indexed: 12/02/2022] Open
Abstract
Neurofibrosarcoma is a rare malignant neoplasm of the head and neck region and accounts for 8% to 16% of all cases. Its origin is varied and may stem from cells of the peripheral nerves, develop de novo, or result from malignant transformation of preexisting neurofibromas. Because the features of neurofibrosarcomas are heterogeneous, the data retrieved during clinical examinations are of great aid for diagnosis. In this case, owing to clinical features and the fact that the patient had neurofibromatosis type 1, the hypothesis of neurofibrosarcoma was promptly established. The final diagnosis was confirmed by associating clinical, imaging, and pathological data. After the treatment, the patient has been followed up for 10 years, with no evidence of recurrence.
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Affiliation(s)
- Juliane Pirágine Araujo
- Universidade de São Paulo, School of Dentistry, Department of Stomatology. São Paulo, SP, Brazil
| | | | - Viviana Lanel
- Hospital Heliopolis, Department of Stomatology. São Paulo, SP, Brazil
| | - Marcelo Marcucci
- Hospital Heliopolis, Department of Stomatology. São Paulo, SP, Brazil
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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.
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Aswath N, Manigandan T, Sankari SL, Yogesh L. A rare case of palatal schwannoma with literature review. J Oral Maxillofac Pathol 2019; 23:36-39. [PMID: 30967721 PMCID: PMC6421914 DOI: 10.4103/jomfp.jomfp_242_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Schwannoma or neurilemmoma is a benign, slow-growing nerve sheath tumor arising from Schwann cells of the cranial, peripheral or autonomic nerves. Approximately 25%–40% of schwannomas occur in the head and neck region. Occurrences of intraoral schwannomas are rare with reported prevalence being 1%. Intraorally, schwannomas occur in the tongue, palate, buccal mucosa, lips and gingiva. This article provides an insight into a rare case of palatal schwannoma with literature review.
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Affiliation(s)
- Nalini Aswath
- Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - T Manigandan
- Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Lakshanika Yogesh
- Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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Abstract
A 55 year old male patient reported in the department of oral and maxillofacial surgery with a chief complaint of swelling on right side of face from last 2 months. He reported a progressive increase in the swelling. Pain and discomfort was present from last 7 days with increased swelling, and reduced mouth opening. On examination, the face appeared asymmetrical with a swelling in the right cheek which was small, smooth, dome shaped, present approximately 1.5 cm anterior to tragus. Overlying skin was of normal colour. The patient was afebrile. Mouth opening was 25 mm.
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Affiliation(s)
- Aviral Agrawal
- Department of Oral and Maxillofacial Surgery, Kalpana Chawala Government Medical College, Karnal, Haryana, India
| | - Virendra Singh
- Department of Oral and Maxillofacial Surgery, PGIDS, Rohtak, Haryana, India
| | - Pradeep Kumar
- Department of Oral and Maxillofacial Surgery, PGIDS, Rohtak, Haryana, India
| | - Amrish Bhagol
- Department of Oral and Maxillofacial Surgery, PGIDS, Rohtak, Haryana, India
| | - Anjali Narwal
- Department of Oral Pathology, PGIDS, Rohtak, Haryana, India
| | - Ishwar Singh
- Department of Neurosurgery, PGIMS, Rohtak, Haryana, India
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Abstract
Schwannomas are benign encapsulated perineural tumors. The head and neck region is the most common site. Intraoral origin is seen in only 1% of cases, tongue being the most common site; its location in the palate is rare. We report a case of hard-palate schwannoma with bony erosion which was immunohistochemically confirmed. The tumor was excised completely intraorally. After two months of follow-up, the defect was found to be completely covered with palatal mucosa.
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Affiliation(s)
- Pradyumna Kumar Sahoo
- Department of Surgical Oncology, Cancer Centre Welfare Home and Research Institute, Mahatma Gandhi Road, Thakurpukur, Kolkata, West Bengal, India
| | - Palash Kumar Mandal
- Department of Pathology, Cancer Centre Welfare Home and Research Institute, Mahatma Gandhi Road, Thakurpukur, Kolkata, West Bengal, India
| | - Saradindu Ghosh
- Department of Surgical Oncology, Cancer Centre Welfare Home and Research Institute, Mahatma Gandhi Road, Thakurpukur, Kolkata, West Bengal, India
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Rapidly progressing soft tissue mass of the anterior mandibular region. Malignant peripheral nerve sheath tumor. ACTA ACUST UNITED AC 2009; 107:607-11. [PMID: 19201222 DOI: 10.1016/j.tripleo.2008.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Revised: 11/03/2008] [Accepted: 11/19/2008] [Indexed: 11/20/2022]
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Chao JC, Ho HC, Huang CC, Tzeng JE. Malignant schwannoma of the mandible: A case report. Auris Nasus Larynx 2007; 34:287-91. [PMID: 17049778 DOI: 10.1016/j.anl.2006.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Revised: 09/05/2006] [Accepted: 09/21/2006] [Indexed: 11/30/2022]
Abstract
This article describes a 59-year-old woman with a rare malignant schwannoma invading the left mandible. The clinical, radiological, pathological findings, treatment, and prognosis of our patient are discussed in detail. A 4-year cure was achieved by radical surgery and concurrent chemoradiotherapy (CCRT). In addition, we also review and summarize relevant literature on malignant schwannoma.
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Affiliation(s)
- Jiung-Chih Chao
- Department of Otolaryngology, National Cheng Kung University Hospital, Tainan, Taiwan
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Rapidly Growing Gingival Malignant Peripheral Nerve Sheath Tumour with Lung and Liver Metastases. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0915-6992(06)80045-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Oğütcen-Toller M, Metin M, Karagöz F. Cellular schwannoma of the mandible: a case report. J Oral Maxillofac Surg 2001; 59:826-8. [PMID: 11429752 DOI: 10.1053/joms.2001.24310] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Johnson PJ, Lydiatt DD, Hollins RR, Rydlund KW, Degenhardt JA. Malignant nerve sheath tumor of the nasal septum. Otolaryngol Head Neck Surg 1996; 115:132-4. [PMID: 8758642 DOI: 10.1016/s0194-5998(96)70148-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- P J Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, 68198-1225, USA
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Redman RS, Guccion JG, Spector CJ, Keegan BP. Cellular schwannoma of the mandible: a case report with ultrastructural and immunohistochemical observations. J Oral Maxillofac Surg 1996; 54:339-44. [PMID: 8600243 DOI: 10.1016/s0278-2391(96)90756-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- R S Redman
- Department of Veterans Affairs Medical Center, Washington, DC 20422, USA
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