Malignant peripheral nerve sheath tumour of the tongue

Malignant peripheral nerve sheath tumour of the oral and maxillofacial region-A systematic review

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.

Lingual Malignant Peripheral Nerve Sheath Tumor in a Chinese Pug Dog

A 9-year-old spayed/female Chinese Pug dog presented for evaluation of a mass located on the rostral aspect of the tongue. An incisional biopsy was acquired, submitted, and interpreted as a possible granular cell tumor based on hematoxylin and eosin, and periodic acid Schiff histopathologic staining characteristics. The diagnosis was supported by immunohistochemical evaluation that was positive for S-100, vimentin, and neuron-specific enolase. Based on the absence of mitotic figures in the incisional biopsy, a partial glossectomy was performed with gross margins of at least 1-cm. The excisional biopsy revealed significant features of malignancy, with neoplastic cells in close association with peripheral nerves, consistent with malignant peripheral nerve sheath tumor. Tumor-free margins were obtained, and the glossectomy had expected healing with no recurrence apparent 6-months following surgery.

Malignant peripheral nerve cell tumour

Malignant Peripheral Nerve Sheath Tumour (MPNST) also termed as spindle cell malignancy of the peripheral nerve schwann cell or neurogenic sarcoma represents 10% of all soft tissue sarcomas. The tumour is usually found in lower extremities and only 10% to 20% of all lesions occur in head and neck region thus making it a rare entity. Central involvement, particularly in the jaw bones is quite unusual. Neurofibroma is one of the common nerve sheath tumours occurring in the soft tissues and generally appears in neurofibromatosis I (NF-I or von recklinghausen's disease). MPNST are uncommon sarcomas that almost always arise in the soft tissues. Here we report a case of intraosseous peripheral nerve sheath tumour occurring in the mandible and discuss the surgical management with adjuvant and neoadjuvant treatment plan.