Myxoid neurothekeoma of the oral mucosa: an unusual benign tumor

Oral nerve sheath myxoma: a rare and unusual intraoral neoplasm

We present a rare case of intraoral nerve sheath myxoma. Clinically, the neoplasm mimics many other oral mucosal pathosis, underscoring the importance of histopathology in ensuring accurate diagnosis of oral mucosal lesions. Reports of intraoral nerve sheath myxomas are essential to enhance our understanding of this rare intraoral entity.

Neurothekeomas of the thoracic and lumbar area in an adult man: A case report

Neurothekeomas are unusual benign soft tissue tumors of the peripheral nervous system, which commonly occur on the head, neck and upper extremities of young females in the second and third decades of life. This is the first case report of neurothekeoma developing simultaneously in the thoracic and lumbar area in a 51-year-old male. The two tumors were completely excised along the capsule under local anaesthesia and the incisions were closed in layers following adequate hemostasis. Histopathologically, the examination of the microscopic slides from the thoracic and lumbar masses revealed the presence of spindle and similar epithelioid cells arranged in fascicles, often in a geographical pattern, in a background of myxoid stroma. The immunohistochemical analysis demonstrated that the tumor cells were positive for vimentin, CD57 and actin and negative for S-100 protein, HMB-45 and CD34. The tumors were diagnosed as neurothekeomas. The patient remains alive and well on follow-up at 7 years, without evidence of recurrence.

Intraoral nerve sheath myxoma: case report and systematic review of the literature

BACKGROUND

Oral nerve sheath myxoma (NSM) is an uncommon benign neoplasm with Schwann-cell origin, which is frequently mistaken for neurothekeoma. We report a case of NSM on the buccal mucosa in a 42-year-old woman. This case is compared with previously reported cases and a systematic review is performed.

METHODS AND RESULTS

We conducted a case report and systematic review of oral cases considered true NSMs. A literature search was performed using PubMed, Lilacs, Scielo, Cochrane, SciVerse Scopus, Web of Science, and Embase electronic database. Twenty-five cases of oral NSM were included in the systematic review.

CONCLUSION

Oral NSM is rare and may represent a diagnostic challenge for pathologists. To confirm the diagnosis of NSM, the evaluation of S-100 protein expression or other neural marker is essential. The use of the terms NSM and neurothekeoma as synonymous or as variants of the same tumor should be avoided, because they are clearly distinct lesions.

Schwannoma causing resorption of zygomatic arch

Schwannoma (also known as neurilemmoma, peripheral glioma and peripheral nerve sheath tumor) is a common, histologically distinctive, benign, usually encapsulated, peripheral nerve tumor of Schwann cell origin. Schwannomas can appear anywhere in the body, but are more frequently reported in the head and neck with an incidence of 25-48% in maxillofacial region. Resorption of bones due to schwannoma is rarely noticed in maxillofacial region. We hereby present a case report of schwannoma in a 35-year-old female, causing resorption of zygomatic arch along with review of literature.

[Neurothekeoma of the orbit]

AIM

The aim of this study was to present a rare benign tumour of neural origin located in the orbit.

MATERIAL AND METHODS

Authors describe case of six-year-old boy with tumour of the right orbit, upper eyelid and right zygomatic fossa. Medical history revealed gradually increasing in size, painless tumour. Before admission to the hospital computed tomography was taken to assess the size, localization of the tumour and to plan the proper treatment.

RESULTS

The patient was operated on using Krönlein approach. Tumour was removed in macroscopically radical limits without need to incise the muscles responsible for eye movement. Histopathological examination revealed: Neurothekeoma, classic type. During one year follow-up there was no recurrence.

CONCLUSION

Neurothekeoma may occur in young boys in eyelid and orbit. A unique localization of neurothekeoma in the orbit, close to the lacrimal gland shows that this kind of histopatological tumours may infiltrate deeper tissues. Surgical treatment of neurothekeoma is the same as in other benign tumours.

Nerve Sheath Myxoma of the Gingiva: Report of a Rare Case and Review of the Literature

BACKGROUND

Nerve sheath myxoma (NSM) is an extremely rare benign neoplasm in the oral cavity. This paper describes the first case, to our knowledge, of NSM in the gingival mucosa of an 84-year-old female patient.

METHODS

Intraoral examination revealed a painless and well-defined nodule in the lingual gingival mucosa of the right mandibular lateral incisor, which measured approximately 1.0 cm in diameter. The lesion was fully excised under local anesthesia, without intercurrences. Hematoxylin and eosin staining was performed in 5-microm sections for histopathologic analysis. Immunohistochemical reactions against vimentin and S-100 protein were carried out in 3-microm histologic sections in accordance with manufacturers' instructions.

RESULTS

The patient's medical history and an extraoral exam did not reveal other abnormalities. The patient wore a removable partial denture in the affected area. A trauma-induced gingival hyperplasia was the main diagnostic hypothesis. Microscopically, the lesion was composed of an abundant myxoid matrix and stellated and spindle-shaped cells arranged in lobules separated by fine fibrous septa. The cells presented strong positivity for vimentin and S-100 protein. According to the histopathologic and immunohistochemical features, the diagnosis of NSM was established. After 9 months of treatment, no signs or symptoms of recurrences have been observed.

CONCLUSION

Although NSM is an extremely rare oral tumor, it should be considered in the clinical differential diagnosis of gingival nodules.

Schwannoma with secondary erosion of mandible: case report with a review of the literature

Schwannoma (neurilemmoma) is a common, histologically distinctive, benign, usually encapsulated, peripheral nerve tumour of Schwann cell origin. We report a case of schwannoma arising from soft tissue near the mandible. A 53-year-old female presented at our department with painless swelling of lingual mucosa of the mandible. The first molar was extracted 20 months before. Panoramic radiograph showed a suspected residual cyst. It was impossible to determine prior to surgery whether this was a peripheral nerve sheath tumour. The lesion was completely removed; the tumour appears to have originated in soft tissue and caused secondary erosion of the mandible.

Spinal nerve sheath myxoma (neurothekeoma)

Nerve sheath myxoma (NSM) is a rare, benign tumor of predominantly cutaneous location. They usually arise from small cutaneous nerves in the head, neck, and extremities, but exceptionally they arise from spinal nerve roots. Only three cases of intraspinal NSM have been reported. Herein is describe two additional cases of spinal NSM. The patients were 64-year-old and 31-year-old men who presented with low back pain. Spine magnetic resonance imaging showed small intradural extramedullary masses at the L2-3 level. Both tumors had typical histological features of myxoid-type NSM. The tumors had a strong immunoreactivity for vimentin, S-100 protein, and neuron-specific enolase and focal expression of epithelial membrane antigen and phosphorylated neurofilament. Ultrastructural observation of tumor cells with perineurial, fibroblast-like, and Schwann-cell differentiation suggests an origin from nerve sheath precursor cells.