Ancient schwannoma of the tongue: a case-report and literature review
Keywords:
tongue schwannoma, intramural schwannoma, tongue surgery, schwann cells, s-100Abstract
Schwannomas are benign tumors arising from Schwann cells of the nerve. Although they commonly appear in the soft tissues of the head and neck (25%), the intraoral origin (1%) and the ancient histological subtypes represent the rarest variant. Specific diagnosis is difficult and often delayed. Radiological examination can be helpful, but complete excision remains the treatment of choice to obtain histological information and reduce the risk of recurrence. We report a rare case of intramural schwannoma of the tongue in a 80-year-old male patient, excised completely via a transoral approach. Histophatological examination and immunohistochemistry confirmed diagnosis and the patient had no postoperative complications. We performed a literature review with a PubMed search about schwannomas of the mobile tongue about the last 30 years. We found 585 articles, of which 54 met the inclusion criteria with a total of 90 cases of schwannoma of the tongue. We finally described the most relevant features of these tumors and their management.
References
Bansal R, Trivedi P, Patel S. Schwannoma of the tongue. Oral Oncol Extra. 2005;41(2):15-17. doi:10.1016/j.ooe.2004.09.003.
Salehinejad J, Sahebnasagh Z, Saghafi S, Sahebnasagh Z, Amiri N. Intraoral ancient schwannoma: A systematic review of the case. Dent Res J. 2017;14(2):10.
Karaca CT, Habesoglu TE, Naiboglu B, et al. Schwannoma of the tongue in a child. Am J Otolaryngol. 2010;31(1):46-48. doi:10.1016/j.amjoto.2008.09.010.
Arda H, Akdogan O, Arda N, Sarikaya Y. An unusual site for an intraoral schwannoma: a case report. Am J Otolaryngol. 2003;24(5):348-350. doi:10.1016/S0196-0709(03)00064-4.
Magro G, Broggi G, Angelico G, et al. Practical Approach to Histological Diagnosis of Peripheral Nerve Sheath Tumors: An Update. Diagnostics. 2022;12(6):1463. doi:10.3390/diagnostics12061463.
Parizel PM, Simoens WA, Matos C, Verstraete KL. Tumors of Peripheral Nerves. In: De Schepper AM, Parizel PM, Ramon F, De Beuckeleer L, Vandevenne JE, eds. Imaging of Soft Tissue Tumors. Springer; 1997:271-298. doi:10.1007/978-3-662-07859-4_17.
Moreno-García C, Pons-García MA, González-García R, Monje-Gil F. Schwannoma of Tongue. J Maxillofac Oral Surg. 2014;13(2):217-221. doi:10.1007/s12663-010-0101-0.
Haider MohdY, Rahim M, Bashar NMK, Hossain MdZ, Islam SMJ. Schwannoma of the Base of the Tongue: A Case Report of a Rare Disease and Review of Literatures. Foroulis C, ed. Case Rep Surg. 2020;2020:1-9. doi:10.1155/2020/7942062.
FECHNER RE. Resident’s Page. Arch Otolaryngol Neck Surg. 1991;117(8):926-929. doi:10.1001/archotol.1991.01870200120021.
Gallesio C, Berrone S. [Schwannoma located in the tongue. A clinical case report]. Minerva Stomatol. 1992;41(12):583-590.
Williams HK, Cannell H, Silvester K, Williams DM. Neurilemmoma of the head and neck. Br J Oral Maxillofac Surg. 1993;31(1):32-35. doi:10.1016/0266-4356(93)90094-d.
Nakayama H, Gobara y., Shimamoto F, Kajihara H. Ancient Schwannoma of the Oral Floor and Ventricular Portion of the Tongue: A Case Report and Review of the Literature. Jpn J Clin Oncol. 1996;26(3):185-188. doi:10.1093/oxfordjournals.jjco.a023205.
Pfeifle R, Baur DA, Paulino A, Helman J. Schwannoma of the tongue: Report of 2 cases. J Oral Maxillofac Surg. 2001;59(7):802-804. doi:10.1053/joms.2001.24298.
Go JH. Benign peripheral nerve sheath tumor of the tongue. Yonsei Med J. 2002;43(5):678-680. doi:10.3349/ymj.2002.43.5.678.
Pahwa R, Khurana N, Chaturvedi KU, Raj A. Neurilemmoma of tongue. Indian J Otolaryngol Head Neck Surg Off Publ Assoc Otolaryngol India. 2003;55(3):193-194. doi:10.1007/BF02991952.
Cinar F, Cinar S, Harman G. Schwannoma of the tip of the tongue in a child. Plast Reconstr Surg. 2004;114(6):1657-1658.
Hwang K, Kim SG, Ahn SI, Lee SI. Neurilemmoma of the tongue. J Craniofac Surg. 2005;16(5):859-861. doi:10.1097/01.scs.0000164333.81428.f3.
Vafiadis M, Fiska A, Panopoulou M, Assimakopoulos D. A clinical case report of a Schwannoma on the tip of the tongue. B-ENT. 2005;1(4):201-204. PMID: 16429754.
Hsu YC, Hwang CF, Hsu RF, Kuo FY, Chien CY. Schwannoma (neurilemmoma) of the tongue. Acta Otolaryngol (Stockh). 2006;126(8):861-865. doi:10.1080/00016480500527219.
Enoz M, Suoglu Y, Ilhan R. Lingual schwannoma. J Cancer Res Ther. 2006;2(2):76-78. doi:10.4103/0973-1482.25856.
Jethanamest D, Kanowitz SJ, Tran TN. Radiology quiz case 1. Schwannoma of the tongue. Arch Otolaryngol Head Neck Surg. 2006;132(12):1384, 1386-1387. doi:10.1001/archotol.132.12.1384.
Patnayak R, Anuradha SVN, Uppin SM, Sundaram C, Raju GSN, Jena A. Schwannoma of tongue – A case report and short review of literature. Acta Oncol. 2007;46(2):265-266. doi:10.1080/02841860600897959.
Pereira LJ, Iucif Pereira PP, dos Santos J de P, Reis Filho VF, Dominguete PR, Costa Pereira A. Lingual Schwannoma Involving The Posterior Lateral Border Of The Tongue In A Young Individual: Case Report. J Clin Pediatr Dent. 2008;33(1):59-62. doi:10.17796/jcpd.33.1.h131208u28306576.
Bonan PRF, Júnior M, Mol VC, Almeida OPD. Multinodular neurilemmoma of the tongue: a case report with differential immunohistochemical profile. MINERVA Stomatol. 2008;57(1):5. PMID: 18427374.
Cohen M, Wang MB. Schwannoma of the tongue: two case reports and review of the literature. Eur Arch Otorhinolaryngol. 2009;266(11):1823-1829. doi:10.1007/s00405-008-0907-2.
Gupta P, Garg A, Dhingra KK, Jain D, Kohli K, Khurana N. Schwannoma tongue: a rare entity. ANZ J Surg. 2009;79(1-2):93-94. doi:10.1111/j.1445-2197.2008.04818.x.
Jeffcoat BT, Pitman KT, Brown AS, Baliga M. Schwannoma of the Oral Tongue. The Laryngoscope. 2010;120(S4):S154-S154. doi:10.1002/lary.21618.
Naidu G, Sinha S. Schwannoma of the tongue: An unusual presentation in a child. Indian J Dent Res. 2010;21(3):457. doi:10.4103/0970-9290.70790.
Catalfamo L, Lombardo G, Nava C, et al. Tongue Schwannoma: Clinicopathological Findings. J Craniofac Surg. 2011;22(3):1158-1161. doi:10.1097/SCS.0b013e318210bb2f.
Lukšić I, Müller D, Virag M, Manojlović S, Ostović KT. Schwannoma of the tongue in a child. J Cranio-Maxillofac Surg. 2011;39(6):441-444. doi:10.1016/j.jcms.2010.10.004.
Ferrari L, Fonseca JJS. Schwannoma of the Tongue With a Happy Ending. Int J Surg Pathol. 2011;19(4):497-498. doi:10.1177/1066896911413096.
Husain S, Yunus MRM, Ramli R, Athar PPSH. Schwannoma of the tongue in a ten-year old child. JPMA J Pak Med Assoc. 2011;61(5):500-501. PMID: 22204190.
Al-Mahdi AH, Al-khurrhi LE, Atto GZ, Dhaher A. Plexiform Hypoglossal Schwannoma of the Tongue and the Submandibular Region: J Craniofac Surg. 2012;23(5):1563-1565. doi:10.1097/SCS.0b013e31825ab4fb.
Manna F, Barbi E, Murru F, Bussani R. Lingual schwannoma in pediatric patients. J Craniofac Surg. 2012;23(5):e454-456. doi:10.1097/SCS.0b013e318262d9c7.
Lira RB, Gonçalves Filho J, Carvalho GB, Pinto CA, Kowalski LP. Lingual schwannoma: case report and review of the literature. Acta Otorhinolaryngol Ital Organo Uff Della Soc Ital Otorinolaringol E Chir Cerv-facc. 2013;33(2):137-140.
Ferreira DC, Nogueira G, Cancio VA, et al. Loss of lingual sensitivity and slightly increased size signaling schwannoma in a patient with mixed conjunctive tissue disease: LINGUAL SCHWANNOMA IN A PATIENT WITH MIXED CONJUNCTIVE TISSUE DISEASE. Spec Care Dentist. 2013;33(6):301-303. doi:10.1111/j.1754-4505.2012.00308.x.
Bhola N, Jadhav A, Borle R, Khemka G, Bhutekar U, Kumar S. Schwannoma of the Tongue in a Paediatric Patient: A Case Report and 20-Year Review. Case Rep Dent. 2014;2014:1-5. doi:10.1155/2014/780762.
Feltes-Ochoa RA, Maseda-Pedrero R, Ruíz-Burguillos E. Schwannoma of the Tongue. Actas Dermo-Sifiliográficas Engl Ed. 2015;106(6):512-514. doi:10.1016/j.adengl.2015.05.007.
Kavčič J, Božič M. Schwannoma of the tongue. BMJ Case Rep. Published online October 8, 2016:bcr2016215799. doi:10.1136/bcr-2016-215799.
Badar Z, Farooq Z, Zaccarini D, Ezhapilli SR. Tongue base schwannoma: differential diagnosis and imaging features with a case presentation. Radiol Case Rep. 2016;11(4):336-340. doi:10.1016/j.radcr.2016.10.001.
Sugawara C, Takahashi A, Kawano F, Kudo Y, Ishimaru N, Miyamoto Y. Intraoral ultrasonography of tongue mass lesions. Dentomaxillofac Radiol.:14.
Medhi J, Laskar HA, Das DJ, et al. Management of Large Tongue Schwannoma - A Short Report. Iran J Otorhinolaryngol. 2016;28(85):168. PMID: 27280106.
Qayoom S, Khan S, Bahadur S, Jetley S. Lingual schwannoma: A cytological diagnosis. J Cytol. 2016;33(2):111. doi:10.4103/0970-9371.182540.
Lee EY, Kim JJ, Seok H, Lee JY. Schwannoma of the tongue: a case report with review of literature. Maxillofac Plast Reconstr Surg. 2017;39(1):17. doi:10.1186/s40902-017-0116-2.
Abreu I, Roriz D, Rodrigues P, Moreira Â, Marques C, Alves FC. Schwannoma of the tongue—A common tumour in a rare location: A case report. Eur J Radiol Open. 2017;4:1-3. doi:10.1016/j.ejro.2017.01.002.
Amer SM, Ukudeyeva A, Pine HS, Campbell GA, Clement CG. Plexiform Schwannoma of the Tongue in a Pediatric Patient with Neurofibromatosis Type 2: A Case Report and Review of Literature. Case Rep Pathol. 2018;2018:1-4. doi:10.1155/2018/9814591.
Diplan J, Cavallo P, de los Santos S. Anterior Midline Glossotomy Approach for Large Schwannoma of the Tongue: Case Report. Clin Med Insights Ear Nose Throat. 2018;11:117955061878693. doi:10.1177/1179550618786935.
Sharma P, Zaheer S, Goyal S, et al. Clinicopathological analysis of extracranial head and neck schwannoma: A case series. J Cancer Res Ther. 2019;15(3):659. doi:10.4103/jcrt.JCRT_1125_16.
Shashikumar T, Tejaswini JS, Bellad S, et al. Ancient Schwannoma: A Rare Intramural Intra-lingual Lesion. Indian J Otolaryngol Head Neck Surg. 2019;71(S1):816-819. doi:10.1007/s12070-019-01647-5.
Thompson LDR, Koh SS, Lau SK. Tongue Schwannoma: A Clinicopathologic Study of 19 Cases. Head Neck Pathol. 2020;14(3):571-576. doi:10.1007/s12105-019-01071-9.
Barca I, Novembre D, Elvis K, Zuccalà V, Cristofaro MG. A rare case of ancient schwannoma of the tongue. Ann Ital Chir. 2020;9.
Kumar M, Rao M, Elhence P, Kaushal D, Yadav T. Schwannoma of head-and-neck region: A clinical chameleon – Report of two cases occurring at rare sites with unusual clinical manifestations. J Oral Maxillofac Pathol. 2020;24(1):164. doi:10.4103/jomfp.JOMFP_13_20.
Chen YL, He DQ, Yang HX, Dou Y. Multiple schwannomas with pseudoglandular element synchronously occurring under the tongue: A case report. World J Clin Cases. 2020;8(22):5611-5617. doi:10.12998/wjcc.v8.i22.5611.
Ahmed S, Al Dayel O, Tabassum N, et al. Lingual schwannoma in an adolescent girl- A diagnostic challenge. J Fam Med Prim Care. 2020;9(3):1775. doi:10.4103/jfmpc.jfmpc_1142_19.
Ohta K, Yoshimura H. Schwannoma of the tongue. CMAJ Can Med Assoc J J Assoc Medicale Can. 2021;193(3):E98. doi:10.1503/cmaj.201039.
Yun CB, Kim YM, Choi JS, Kim JW. Pediatric schwannoma of the tongue: A case report and review of literature. World J Clin Cases. 2021;9(24):7212-7217. doi:10.12998/wjcc.v9.i24.7212.
Chi AC, Neville BW, Cheng L. Plexiform Schwannoma of the Oral Cavity: Report of Eight Cases and a Review of the Literature. Head Neck Pathol. 2021;15(1):288-297. doi:10.1007/s12105-020-01159-7.
Agha‐Hosseini F, Moosavi M, Aminishakib P, Yousefian M. A fast‐growing schwannoma of the tongue in a 15‐year‐old Iranian male: Review of literature and case report. Clin Case Rep. 2021;9(6). doi:10.1002/ccr3.4266.
Alrohaimi FA, Alsadah SA, Althaqib GA. Lingual schwannoma in an adolescent boy: A case report. Ann Med Surg. 2021;65:102216. doi:10.1016/j.amsu.2021.102216.
Phulware RH, Sardana R, Chauhan DS, Ahuja A, Bhardwaj M. Extracranial Schwannomas of the Head and Neck: A Literature Review and Audit of Diagnosed Cases Over a Period of Eight Years. Head Neck Pathol. 2022;16(3):707-715. doi:10.1007/s12105-022-01415-y.
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:10.5125/jkaoms.2016.42.1.60.
Harazono Y, Kayamori K, Sakamoto J, et al. Retrospective analysis of schwannoma in the oral and maxillofacial region: clinicopathological characteristics and specific pathology of ancient change. Br J Oral Maxillofac Surg. Published online July 2021:S026643562100262X. doi:10.1016/j.bjoms.2021.07.014.
Goldblum JR, Weiss SW, Folpe AL. Enzinger and Weiss’s Soft Tissue Tumors E-Book. Elsevier Health Sciences; 2013.
Lira RB, Filho JG, Carvalho GB, Pinto CA, Kowalski LP. Lingual schwannoma: case report and review of the literature. :4. PMID: 23853407.
de Bree R, Westerveld GJ, Smeele LE. Submandibular approach for excision of a large schwannoma in the base of the tongue. Eur Arch Otorhinolaryngol. 2000;257(5):283-286. doi:10.1007/s004050050241.
Sayed S, Rane P, Deshmukh A, et al. Ancient schwannoma of the parapharynx causing dysphagia: a rare entity. Ann R Coll Surg Engl. 2012;94(7):e10-e13. doi:10.1308/003588412X13373405385737.
López JI, Ballestin C. Intraoral schwannoma. A clinicopathologic and immunohistochemical study of nine cases. Arch Anat Cytol Pathol. 1993;41(1):18-23.
Colreavy MP, Lacy PD, Hughes J, et al. Head and neck schwannomas – a 10 year review. J Laryngol Otol. 2000;114(2):119-124. doi:10.1258/0022215001905058.
Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: Radiologic-Pathologic Correlation. RadioGraphics. 2004;24(5):1477-1481. doi:10.1148/rg.245045001.
Skolnik AD, Loevner LA, Sampathu DM, et al. Cranial Nerve Schwannomas: Diagnostic Imaging Approach. RadioGraphics. 2016;36(5):1463-1477. doi:10.1148/rg.2016150199.
Wippold FJ, Lubner M, Perrin RJ, Lammle M, Perry A. Neuropathology for the Neuroradiologist: Antoni A and Antoni B Tissue Patterns. Am J Neuroradiol. 2007;28(9):1633-1638. doi:10.3174/ajnr. A0682.
Medhi J, Laskar HA, Das DJ, Shunyu NB, Jitani A, Raphael V, Thabah R. Management of Large Tongue Schwannoma - A Short Report. Iran J Otorhinolaryngol. 2016 Mar;28(85):168. PMID: 27280106.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Arianna Soncini, Maria Silvia Lazio, Daria Salsi, Chiara Celaschi, Domenico Cuda
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
