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Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas

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Abstract

Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract, rarely involving the head/neck region. This is the first reported case involving the submandibular gland. We present a case in a 34 year old man with 4.5 cm submandibular mass. Fine needle aspiration suggested a spindle cell lesion. Frozen section evaluation raised the possibility of mucoepidermoid carcinoma. Resection showed a well circumscribed mass with a mucoid appearance. Histologic findings include a lobular architecture with fibrous septa, a lympho-plasmacytic infiltrate, and scattered lymphoid aggregates at the periphery. There are two distinct histologic patterns with solid areas of spindle cells and areas of spindle/ovoid cells with a microcystic pattern in a myxoid background. The tumor has a pushing border, with extension into adipose and adjacent parenchyma, without cytologic atypia or necrosis. Immunohistochemical stains are positive for S-100 and CD34, and negative for calponin, mammoglobin, ALK1, p63, ER, GFAP, SMA, desmin, cytokeratin 7, cytokeratin AE1/AE3, and C-Kit. Mucicarmine stain is negative. Recognition of this benign unusual variant of schwannoma is paramount for appropriate conservative treatment due to the morphologic and immunohistochemical overlap with primary salivary gland carcinomas.

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Authors and Affiliations

  1. Department of Pathology, New York University School of Medicine, 462 1st Avenue, Office 4W35, New York, NY, 10016, USA

    Ryan P. Lau, Jonathan Melamed, Melissa Yee-Chang & Ronaldo Zamuco

  2. Department of Otolaryngology – Head and Neck Surgery, New York University School of Medicine, 462 First Avenue, Suite 5SE5, New York, NY, 10016, USA

    Sonya Marcus & Babak Givi

Authors
  1. Ryan P. Lau
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  2. Jonathan Melamed
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  3. Melissa Yee-Chang
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  6. Ronaldo Zamuco
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Correspondence to Ryan P. Lau.

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Lau, R.P., Melamed, J., Yee-Chang, M. et al. Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas. Head and Neck Pathol 10, 374–378 (2016). https://doi.org/10.1007/s12105-015-0674-5

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