Lingual schwannoma of submandibular region - a unique case in a rare location: a case report and literature review
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20253818Keywords:
Lingual schwannoma, Neurilemmoma, Submandibular schwannoma, Benign nerve sheath tumorAbstract
Schwannomas are uncommon benign nerve sheath tumors that rarely arise in the oral cavity. Among those found in the oral cavity, tongue is the predominant site of involvement. Lingual schwannomas originating in the submandibular region are exceptionally rare and pose a challenge in diagnosis owing to their nonspecific presentation and resemblance to salivary gland pathologies. Authors report the case of a 15-year-old girl presenting with a two-year history of a painless, progressively enlarging swelling in the left submandibular region, initially suspected to be a submandibular gland lesion. Radiological evaluation with ultrasonography and contrast-enhanced MRI demonstrated a well-defined, lobulated mass adjacent to the gland. The patient underwent surgical excision via a transcervical approach, that revealed the tumor arising from the lingual nerve near the submandibular ganglion. Histopathological examination confirmed the diagnosis of schwannoma, characterized by biphasic Antoni A and Antoni B areas with nuclear palisading. A literature review revealed 125 reported cases of lingual schwannomas, with no gender predilection and a wide age range. Given their infrequent and varied clinical presentation, it is emphasized that lingual schwannomas be considered in the differential diagnosis of submandibular and tongue-associated swellings. Complete surgical excision remains the treatment of choice and offers an excellent prognosis with minimal recurrence risk.
Metrics
References
Yafit D, Horowitz G, Vital I, Locketz G, Fliss DM. An algorithm for treating extracranial head and neck schwannomas. Eur Arch Otorhinolaryngol. 2015;272:2035–8. DOI: https://doi.org/10.1007/s00405-014-3156-6
Lira RB, Gonçalves Filho J, Carvalho GB, Pinto CA, Kowalski LP. Lingual schwannoma: case report and review of the literature. Acta Otorhinolaryngol Ital. 2013;33(2):137.
Enoz M, Suoglu Y, Ilhan R. Lingual schwannoma. J Cancer Res Ther. 2006;2:76–8. DOI: https://doi.org/10.4103/0973-1482.25856
Katti TV, Anantharao AS, Punyashetty KB. Lingual schwannoma in posterior 1/3 of tongue-a rare presentation. J Evid Based Med Healthc. 2014;1(7):529-32. DOI: https://doi.org/10.18410/jebmh/2014/82
Gavin CW, Khee-Chee S, Dennis TH. Extracranial non vestibular head and neck schwannomas: a 10 years’ experience. Ann Acad Med Singap. 2007;36(4):233-40. DOI: https://doi.org/10.47102/annals-acadmedsg.V36N4p233
Awasti SK, Dutta A. Cervical sympathetic chain schwannomas: a case report. Indian J Otolaryngol Head Neck Surg. 2011;63(3):292-4.
Watkinson JC, Gaze MN, Wilson JA, editors. Benign neck disease. In: Stell and Maran’s head and neck surgery. 4th ed. Oxford: Butterworth Heinemann. 2000: 193-194.
Awasti SK, Dutta A. Cervical sympathetic chain schwannomas: a case report. Indian J Otolaryngol Head Neck Surg. 2011;63(3):292-4. DOI: https://doi.org/10.1007/s12070-011-0276-9
Hwang K, Kim SG, Ahn SI, Lee SI. Neurilemmoma of the tongue. J Craniofac Surg. 2005;16(5):859-61. DOI: https://doi.org/10.1097/01.SCS.0000164333.81428.F3
Quintarelli G. Contributo allo studio dei neurinomi del cavo orale. Acta Stomatol Patav. 1956;3:1-16.
Sawhney R, Carron MA, Mathog RH. Tongue base schwannoma: report, review, and unique surgical approach. Am J Otolaryngol. 2008;29:119-22. DOI: https://doi.org/10.1016/j.amjoto.2006.08.003
Anil G, Tan TY. Imaging characteristics of schwannoma of the cervical sympathetic chain: a review of 12 cases. Am J Neuroradiol. 2010;31:1408-12. DOI: https://doi.org/10.3174/ajnr.A2212
Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24:1477-81. DOI: https://doi.org/10.1148/rg.245045001
Nelson W, Chuprevich T, Galbraith DA. Enlarging tongue mass. J Oral Maxillofac Surg. 1998;56:224-7. DOI: https://doi.org/10.1016/S0278-2391(98)90873-4
Shim SK, Myoung H. Neurilemmoma in the floor of the mouth: a case report. J Korean Assoc Oral Maxillofac Surg. 2016;42(1):60. DOI: https://doi.org/10.5125/jkaoms.2016.42.1.60
Naik SM, Goutham MK, Ravishankara S, Appaji MK. Sublingual Schwannoma: a rare clinical entity reported in a hypothyroid female. Int J Head Neck Surg. 2012;3:33-9. DOI: https://doi.org/10.5005/jp-journals-10001-1089
Gallo WJ, Moss M, Shapiro DN, Gaul JV. Neurilemoma: review of the literature and report of five cases. J Oral Surg. 1977;35:235-6.
AL-Alawi YSM, Kolethekkat AA, Saparamadu PAM, Al Badaai Y. Sublingual gland schwannoma: a rare case at an unusual site. Oman Med J. 2014;29:679. DOI: https://doi.org/10.5001/omj.2014.41
Hsu YC, Hwang CF, Hsu RF, Kuo FY, Chien CY. Schwannoma (neurilemmoma) of the tongue. Acta Otolaryngol. 2006;126:861-5. DOI: https://doi.org/10.1080/00016480500527219