Lingual schwannoma in pediatric patients. J Craniofac Surg. 2012;23:e454-e456. [PMID: 22976705 DOI: 10.1097/scs.0b013e318262d9c7]

Pediatric schwannoma of the tongue: A case report and review of literature

BACKGROUND

Neurogenic tumors account for about ten percent of all tumors of childhood, and benign tumor originating from Schwann cells is rare in peripheral nerves. Schwannoma of the tongue is quite rare in children.

CASE SUMMARY

We present the case of an 8-year-old male with schwannoma in the anterolateral tongue. The mass was slow-growing for one year with no pain and discomfort. He underwent transoral mass excision under general anesthesia. Gross examination revealed a smooth surfaced, 17 mm × 14 mm × 7 mm sized, encapsulated nodule with a clear resection margin. Schwannoma of the tongue was confirmed by the pathological exam. He reported no motor or sensory change, such as dysgeusia or paresthesia, or phonation difficulty during postoperative 12 mo follow-up.

CONCLUSION

Schwannoma of the tongue is a rare benign neoplasm in childhood. If a painless firm mass is encountered in the tongue of a child, solid tumors like schwannoma should be considered in the differential diagnosis.

Comprehensive Analyses of Intraoral Benign and Malignant Nerve Sheath Tumors: The Rare Disease Entities Revisited

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.

Palatal schwannoma in a young female patient: report of a case and review of the literature

BACKGROUND

A few cases of oral schwannomas in paediatric patients have appeared in the literature so far; however, there are no studies focusing solely on paediatric oral schwannomas. The aim of this study is to report a case of palatal schwannoma in a young female patient and review the pertinent literature on oral schwannomas in paediatric patients.

CASE REPORT

A 12-year-old girl presented with a growing swelling of 2 weeks duration on the hard palate. With a provisional diagnosis of a salivary gland neoplasm an incisional biopsy was performed under local anesthesia and the histologic examination disclosed an Antony A type schwannoma.

TREATMENT

Complete surgical resection of the lesion was performed under local anaesthesia through a palatal mucosa incision and paraffin gauze was sutured on the surgical area for protection during secondary healing. The bone underlying the tumor was normal. The postoperative period was uneventful and 2 weeks after excision the gauze were removed.

FOLLOW-UP

There have been no signs of recurrence during a 18-month follow up period.

CONCLUSION

A palatal swelling in a child or adolescent may represent a neoplasm, such as a schwannoma and requires careful clinical and radiographic evaluation of the dentition.

Schwannoma of the tongue in a paediatric patient: a case report and 20-year review

Schwannomas (Neurilemmomas) are benign, encapsulated, slow-growing, and usually solitary tumours originating from Schwann cells of the peripheral nerve sheath with uncertain etiology. Approximately 25-48% of cases are seen in the head and neck region, of which 1% appears in the oral cavity. Lingual schwannoma can affect all age groups with peak incidence between the third and sixth decade. We report a rare case of lingual schwannoma in a 14-year-old girl complaining of asymptomatic swelling over lateral border of tongue since two years. Clinical examination revealed a nodule 1.5 × 1 cm in size, rubbery, nontender, smooth at right lateral border of tongue covered by normal mucosa, with no cervical lymphadenopathy. Excisional biopsy of the lesion was done under local anaesthesia. The histological sections spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence-free after one year.