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Hassan SH, Salih KM, Salih AM, Qaradakhy AJ, Abdullah AM, Saeed YA, Muhialdeen AS, Habibullah IJ, Dhahir HM, Kakamad FH, Ahmed MK. Sporadic neurofibroma of facial nerve presenting as parotid gland tumor: a rare case report. J Surg Case Rep 2024; 2024:rjae434. [PMID: 38957521 PMCID: PMC11218767 DOI: 10.1093/jscr/rjae434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/08/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
Intraparotid gland neurofibroma is a rare benign tumor that arises from Schwann cells of the facial nerve within the parotid gland. This case report discusses a 41-year-old woman who experienced a painless preauricular swelling on her right side for over 5 years. Clinical examination and ultrasound revealed a well-defined mass in the parotid gland. The patient underwent total mass excision, resulting in transient facial nerve dysfunction but complete recovery. These tumors often manifest as solitary masses in the parotid region and may compress nearby structures, causing facial paralysis or numbness. Their diagnosis can be challenging due to similarities with other parotid gland tumors and possible associations with neurofibromatosis. Managing intraparotid tumors, including neurofibromas, involves a multidisciplinary approach with input from cytopathologists, radiologists, and surgeons.
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Affiliation(s)
- Shko H Hassan
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Karzan M Salih
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Abdulwahid M Salih
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Surgery, College of Medicine, University of Sulaimani, Zanko Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Aras J Qaradakhy
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Radiology, Shorsh Teaching Hospital, Shorsh Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Ari M Abdullah
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Pathology, Sulaymaniyah Teaching Hospital, Zanko Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Yadgar A Saeed
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Aso S Muhialdeen
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Imad J Habibullah
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Hardi M Dhahir
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Fahmi H Kakamad
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Surgery, College of Medicine, University of Sulaimani, Zanko Street, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization, Hamdi Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Masty K Ahmed
- Scientific Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
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2
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Luzha J, Kopp M, Wiesmüller M, Taha L, Rupp R, Mantsopoulos K, Koch M, Iro H, Sievert M. Diagnostic Challenges and Imaging Considerations for Intraparotid Facial Nerve Schwannoma: A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e942870. [PMID: 38549237 PMCID: PMC10985418 DOI: 10.12659/ajcr.942870] [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: 10/15/2023] [Revised: 02/09/2024] [Accepted: 01/12/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND A mass in the parotid gland usually indicates parotid gland neoplasia. Warthin tumors or pleomorphic adenomas are common differential diagnoses. Less frequently, other differential diagnoses and sites of origin are considered. Schwannomas are rare, benign tumors in the head and neck region. Even more rarely, these tumors occur in the intraparotid course of the facial nerve. In the following, we report about 2 patients in whom a mass in the right parotid gland was found incidentally during magnetic resonance imaging (MRI). CASE REPORT We reviewed data from the literature on intraparotid facial nerve schwannomas (IPFNS) and compared them with those from our cases. The focus was on data such as clinical history, clinical symptoms, electroneurography, and various imaging modalities, such as ultrasonography and MRI combined with diffusion-weighted imaging. CONCLUSIONS It is challenging to distinguish facial nerve schwannomas from other neoplasms. Patient's history, clinical symptoms, MRI examination with diffusion-weighted imaging, and high-resolution ultrasound imaging are decisive factors for diagnosis and should be performed when IPFNS is suspected. Diagnosis and therapy for IPFNS remain challenging. A wait-and-scan approach could be an option for patients with small tumors and good facial nerve function. On the other hand, patients with advanced tumors associated with limited facial nerve function can benefit from surgical approaches or stereotactic radiosurgery.
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Affiliation(s)
- Jeton Luzha
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Markus Kopp
- Department of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marco Wiesmüller
- Department of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Robin Rupp
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Kwon YE. Ancient schwannoma in the parotid gland: A case report and review of the literature. Imaging Sci Dent 2023; 53:239-245. [PMID: 37799744 PMCID: PMC10548156 DOI: 10.5624/isd.20230504] [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: 05/04/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 10/07/2023] Open
Abstract
Schwannomas are uncommon neoplasms of neurologic origin that are rare in the salivary glands. A schwannoma that persists for a long time is referred to as an ancient schwannoma if it is accompanied by degenerative changes on histology. The case described herein involved a 37-year-old man with an ancient schwannoma that had persisted for 20 years in his right parotid gland. Clinically, the lesion presented with swelling and pain. Computed tomography revealed a well-defined, multilocular enhanced lesion. T2-weighted magnetic resonance images displayed multilocular hyperintensity, while T1-weighted images showed a high signal at the lobulated margin and a homogeneous low signal internally. The preoperative diagnosis, based on the lesion's location and imaging diagnosis, was Warthin's tumor. However, a biopsy conducted after surgical excision identified the lesion as a schwannoma with cystic degeneration. This report also presents a summary of the characteristics of rare cases of schwannoma in the major salivary gland based on this case and a literature review.
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Affiliation(s)
- Young-Eun Kwon
- Department of Oral and Maxillofacial Radiology, Kyungpook National University Dental Hospital, Daegu, Korea
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4
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Vrinceanu D, Dumitru M, Popa-Cherecheanu M, Marinescu AN, Patrascu OM, Bobirca F. Extracranial Facial Nerve Schwannoma-Histological Surprise or Therapeutic Planning? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1167. [PMID: 37374372 DOI: 10.3390/medicina59061167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Schwannomas (neurilemomas) are benign, slow-growing, encapsulated, white, yellow, or pink tumors originating in Schwann cells in the sheaths of cranial nerves or myelinated peripheral nerves. Facial nerve schwannomas (FNS) can form anywhere along the course of the nerve, from the pontocerebellar angle to the terminal branches of the facial nerve. In this article, we propose a review of the specialized literature regarding the diagnostic and therapeutic management of schwannomas of the extracranial segment of the facial nerve, also presenting our experience in this type of rare neurogenic tumor. The clinical exam reveals pretragial swelling or retromandibular swelling, the extrinsic compression of the lateral oropharyngeal wall like a parapharyngeal tumor. The function of the facial nerve is generally preserved due to the eccentric growth of the tumor pushing on the nerve fibers, and the incidence of peripheral facial paralysis in FNSs is described in 20-27% of cases. Magnetic Resonance Imaging (MRI) examination is the gold standard and describes a mass with iso signal to muscle on T1 and hyper signal to muscle on T2 and a characteristic "darts sign." The most practical differential diagnoses are pleomorphic adenoma of the parotid gland and glossopharyngeal schwannoma. The surgical approach to FNSs requires an experienced surgeon, and radical ablation by extracapsular dissection with preservation of the facial nerve is the gold standard for the cure. The patient's informed consent is important regarding the diagnosis of schwannoma and the possibility of facial nerve resection with reconstruction. Frozen section intraoperative examination is necessary to rule out malignancy or when sectioning of the facial nerve fibers is necessary. Alternative therapeutic strategies are imaging monitoring or stereotactic radiosurgery. The main factors which are considered during the management are the extension of the tumor, the presence or not of facial palsy, the experience of the surgeon, and the patient's options.
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Affiliation(s)
- Daniela Vrinceanu
- ENT Department, Carol Davila University of Medicine and Pharmacy, 050472 Bucharest, Romania
| | - Mihai Dumitru
- ENT Department, Carol Davila University of Medicine and Pharmacy, 050472 Bucharest, Romania
| | - Matei Popa-Cherecheanu
- Department of Cardiovascular Surgery, "Prof. Dr. Agrippa Ionescu" Emergency Clinical Hospital, 011356 Bucharest, Romania
| | | | - Oana-Maria Patrascu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 050096 Bucharest, Romania
| | - Florin Bobirca
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 011437 Bucharest, Romania
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5
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Mishra PK, Gupta N, Ahmed A, Ahmed M, Sharma SC. A Large Facial Nerve Schwannoma Presenting as a Swelling in Parotid Region-A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:343-347. [PMID: 37206751 PMCID: PMC10188757 DOI: 10.1007/s12070-022-03423-4] [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: 11/01/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
Extratemporal facial nerve schwannomas are rare entity. Pre-operative assessment is mostly inconclusive with differential diagnosis of parotid tumors. We hereby report a case of 28 years female who presented with painless swelling in right parotid region with normal facial nerve function. Ultrasonography was suggestive well circumscribed and homogenous mass arising from the deep lobe of parotid gland. The Fine-needle aspiration cytology came out to be inconclusive. For further characterization of the tumor contrast enhanced MR imaging was performed. The MR imaging revealed well-defined cystic, heterogeneous, pear-shaped mass lesion situated near the stylomastoid foramen. Post operatively the mass came out to be schwannoma on histopathological examination.
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Affiliation(s)
- Pawan Kumar Mishra
- Department of Otorhinolaryngology, Faculty of Medicine, AMU, Aligarh, India
| | - Nainsi Gupta
- Department of Otorhinolaryngology, Faculty of Medicine, AMU, Aligarh, India
| | - Aftab Ahmed
- Department of Otorhinolaryngology, Faculty of Medicine, AMU, Aligarh, India
| | - Murad Ahmed
- Department of Pathology, Faculty of Medicine, AMU, Aligarh, India
| | - S. C. Sharma
- Department of Otorhinolaryngology, Faculty of Medicine, AMU, Aligarh, India
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Singh AK, Kumar JA, Sharma NK, Pandey A, Mishra N, Bera R. Systematic Review of Intra Parotid Facial Nerve Schwannoma and a Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:6268-6284. [PMID: 36742919 PMCID: PMC9895698 DOI: 10.1007/s12070-021-03013-w] [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: 07/20/2021] [Accepted: 11/28/2021] [Indexed: 02/07/2023] Open
Abstract
To evaluate the clinico-epidemiological aspects, pathological features, diagnostic methods, management protocol and functional outcome of the intra-parotid facial nerve schwannoma (IFNS) and to present a case report on intra parotid facial nerve schwannoma. PubMed, ProQuest, Google scholar, Science direct and Scopus were screened for studies. Article selection and data extraction was done by one investigator and other investigator confirmed its accuracy. After abstract and text screening a total of 69 articles were finally selected for the study with the inclusion and exclusion criteria of the systematic review as per PRISMA guidelines. With addition of one case reported to our department. The mean age of diagnosis was 43 ± 16 years with a slight female predominance. The mean duration of the tumour was 29.5 months and the mean size of the tumour on initial diagnosis was 3.6 ± 1.67 cm. Pleomorphic adenoma was the primary diagnosis in 44 cases. Superficial parotidectomy was done in 64 cases followed by resection in 47 cases. Reconstructive treatment was carried out by an end-to-end anastomosis in 3 patients and by facial-hypoglossal anastomosis in 16 patients, GAN cable grafting in 5 patients, a greater auricular nerve graft was done in18 patients and end-to-side interposed sural nerve graft in 8 patients. The type D tumours are treated by extended resection of the facial nerve, which is difficult to reconstruct and also employs a nerve graft that does not often give acceptable recovery of facial function. Facial nerve schwannomas being a rare entity poses a dilemma in diagnosis and management. Managing the lesions is also difficult as intraoperative adherence to the nerve makes a tumour free margin difficult without sacrificing the nerve. At present there is no consensus regarding the management of various types of intra-parotid facial nerve shwannoma.
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Affiliation(s)
- Akhilesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
| | - Janani Anand Kumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
| | - Naresh Kumar Sharma
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
| | - Arun Pandey
- Trauma Center and Superspeciality Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
| | - Nitesh Mishra
- Trauma Center and Superspeciality Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
| | - Rathindranath Bera
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India
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7
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Suárez C, López F, Rodrigo JP, Mendenhall WM, de Bree R, Mäkitie AA, Vander Poorten V, Takes RP, Bondi S, Kowalski LP, Shaha AR, Fernández-Alvarez V, Gutiérrez JC, Zidar N, Chiesa-Estomba C, Strojan P, Sanabria A, Rinaldo A, Ferlito A. Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck. Adv Ther 2022; 39:3449-3471. [PMID: 35689724 DOI: 10.1007/s12325-022-02191-5] [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: 04/01/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Cervical sympathetic chain, brachial plexus, cervical plexus and spinal roots and nerves are the major nerve systems commonly affected. Dumbbell-shaped intra- and extradural tumors occur most commonly in the cervical spine, as well as purely extradural and paravertebral tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques and surgical innovations such as endoscopically assisted approaches and robotic surgery. Microsurgical intracapsular excision of the tumor helped by the use of intraoperative fluorescent dyes and intraoperative neurophysiological monitoring minimize postoperative neural deficit, since most schwannomas are encapsulated. Most tumors can be removed with a low rate of complications and recurrence. Radiotherapy should be considered for growing lesions that are not amenable to surgery. In asymptomatic patients, observation and serial scans is an option for elderly infirm patients.
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Affiliation(s)
- Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain.
| | - Fernando López
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain.
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Avenida de Roma s/n, 33011, Oviedo, Spain.
| | - Juan P Rodrigo
- Instituto de Investigación Sanitaria del Principado de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, Avenida de Roma s/n, 33011, Oviedo, Spain
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vincent Vander Poorten
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
- Otorhinolaryngology, Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefano Bondi
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Luiz P Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center and University of São Paulo Medical School, São Paulo, Brazil
| | - Ashok R Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Julio C Gutiérrez
- Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Carlos Chiesa-Estomba
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastián, Spain
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, 050010, Medellín, Colombia
- CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, 050021, Medellín, Colombia
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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8
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Velez Torres JM, Duarte EM, Diaz-Perez JA, Leibowitz J, Weed DT, Thomas G, Sargi Z, Civantos FJ, Arnold DJ, Gomez-Fernandez C, Montgomery EA, Rosenberg AE. Mesenchymal Neoplasms of Salivary Glands: A Clinicopathologic Study of 68 Cases. Head Neck Pathol 2021; 16:353-365. [PMID: 34251596 PMCID: PMC9187808 DOI: 10.1007/s12105-021-01360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/06/2021] [Indexed: 12/13/2022]
Abstract
Salivary gland neoplasms are uncommon, and most exhibit epithelial differentiation. Mesenchymal neoplasms of the salivary gland are rare, and the incidence ranges from 1.9% to 5%. The aim of this study is to identify the types and clinical-pathological features of mesenchymal salivary neoplasm and review their differential diagnosis. A retrospective search for mesenchymal neoplasms of salivary glands from our institution's pathology archives from the 2004-2021 period and consultation files of one of the authors (AER) was performed. The clinical data were obtained from available medical records, and the histological slides and ancillary studies were retrieved and reviewed. We identified a total of 68 cases that form the study cohort. Thirty-five patients were male, and thirty-three patients were female, with a mean age of 48 years (range, 7 months-79 years), and the male to female ratio was 1:.94. Sixty-three (92.6%) of sixty-eight tumors were benign and included: 38 (56%) lipomas, 9 (13%) hemangiomas, 7 (10.3%) schwannomas, 3 (4.4%) neurofibromas, 3 (4.4%) lymphangioma, 2 (3%) solitary fibrous tumors, 1 (1.5%) myofibroma. Five of sixty-eight (7.4%) were malignant and included: 3 (4.4%) Adamantinoma-like Ewing sarcomas, 1 (1.5%) malignant peripheral nerve sheath tumor (MPNST), and 1 (1.5%) malignant solitary fibrous tumor. The involved sites included: parotid (55), submandibular gland (5), parapharyngeal space (5), buccal mucosa minor salivary gland (2), and sublingual gland (1). Sixty-seven patients underwent surgical resection. One patient with lymphangioma manifested a recurrence/persistence a week post-surgery. One patient with a parotid hemangioma developed post-operative numbness, and another patient developed chronic postauricular pain after surgery. Two patients with MPNST and one patient with adamantinoma-like Ewing sarcoma underwent neoadjuvant chemoradiation and were disease-free after treatment. The remaining 37 patients with available follow-up ranging from 7 days to 96 months (mean, 18 months) had a favorable outcome and were disease-free after treatment. Mesenchymal neoplasms of salivary gland are rare; most are benign and demonstrate adipocytic, endothelial, and schwannian differentiation; awareness of their development is important for adequate diagnosis. The mainstay of treatment is surgical excision, with the extent determined by tumor type. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.
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Affiliation(s)
- Jaylou M. Velez Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | | | - Julio A. Diaz-Perez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Jason Leibowitz
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Donald T. Weed
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Giovanna Thomas
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Zoukaa Sargi
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Francisco J. Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - David J. Arnold
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Carmen Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Elizabeth A. Montgomery
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Andrew E. Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
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Bagga MB, Bhatnagar D, Katoch S. Preauricular Intraparotid Schwannoma: A Rare Presentation with Literature Review. Contemp Clin Dent 2021; 12:191-194. [PMID: 34220163 PMCID: PMC8237817 DOI: 10.4103/ccd.ccd_519_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/21/2020] [Accepted: 08/20/2020] [Indexed: 11/15/2022] Open
Abstract
Schwannoma is a benign tumor rarely found in the intraparotid facial nerve region. It clinically presents as a slow-growing, asymptomatic mass. Due to its rare presentation, preoperative diagnosis is often unclear before surgical removal and histopathological examination. Imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) play an important role in suggesting the nature of mass and narrowing down the differentials. The CT scan offers the advantage to detect the relationship of the facial nerve and osseous changes within the bone, however MRI shows a mass relative to brain type of tissue. We report a rare case of intraparotid facial nerve schwannoma in a 17-year-old female who had sustained swelling in her left preauricular area for 5 years. Ultrasonography and CT findings revealed the impression of pleomorphic adenoma. However, MRI and histopathological findings were characteristic of schwannoma. Thus, this article provides an insight into a rare presentation of schwannoma with literature review.
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Affiliation(s)
- Mun Bhawni Bagga
- Department of Oral Medicine Diagnosis and Radiology, MN DAV Dental College and Hospital, Solan, Himachal Pradesh, India
| | | | - Shiva Katoch
- Department of Prosthodontics, MN DAV Dental College and Hospital, Solan, Himachal Pradesh, India
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10
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Kim KS, Lee H, Choi JH, Hwang JH, Lee SY. Schwannoma of the posterior branch of the great auricular nerve. Arch Craniofac Surg 2020; 21:368-371. [PMID: 33663146 PMCID: PMC7933724 DOI: 10.7181/acfs.2020.00549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/16/2020] [Indexed: 11/11/2022] Open
Abstract
Schwannoma, also known as neurilemmoma, is a tumor of the nerve sheath, which most often occurs in the peripheral nerves of the extremities. Schwannoma can be accompanied by symptoms such as pain, paresthesia, and Tinel sign; however, patients can also be asymptomatic. Here, we present the case of a 17-year-old woman who presented with a slowly growing, asymptomatic, postauricular mass that appeared 10 years prior. Ultrasonography was performed, and the mass was thought to be an epidermal inclusion cyst. However, the clinical manifestation during surgery was not correlated to an epidermal inclusion cyst, leading to the suspicion of schwannoma from the posterior branch of the great auricular nerve. After a meticulous dissection, schwannoma was diagnosed based on a permanent section biopsy. Postoperative complications and recurrence were not observed. Schwannoma in the peripheral nerve area of the face is rare. Therefore, an investigation of tumors that occur where the nerve passes using imaging and clinical features is necessary to confirm the diagnosis of schwannoma and to establish suitable treatment methods.
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Affiliation(s)
- Kwang Seog Kim
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Hyeok Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jun Ho Choi
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Ha Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Sam Yong Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
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