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Schwannoma-Like Pleomorphic Adenoma: Two Cases and a Review of the Literature

  • Stephen H. RothEmail author
  • William C. Faquin
  • Cecilia Gimenez
  • Bhumika Vadalia
  • Douglas K. Frank
  • Jian Yi Li
Original Paper

Abstract

Schwannoma-like pleomorphic adenoma is a rare variant of the common benign salivary neoplasm, pleomorphic adenoma. This entity’s cytomorphology closely mimics a schwannoma, potentially making a diagnosis of cytologic preparations or of surgical specimens a challenge. To the best of our knowledge, there are only six previous reports of schwannoma-like pleomorphic adenoma with eight total cases in the English language literature prior to the addition of the two cases detailed in this report. Our report includes what we believe to be the first documented case of this entity occurring in the submandibular gland. One of our cases occurred in the submandibular gland of a 90-year-old woman and the other occurred in the left parotid gland of a 40-year-old woman. We also examine the diagnostic considerations used to differentiate these two entities.

Keywords

Pleomorphic adenoma Schwannoma Benign Spindle cell lesion Fine-needle aspirate Cytopathology Parotid gland Submandibular gland Schwannoma-like pleomorphic adenoma 

Notes

Acknowledgements

The authors would like to acknowledge Dr. Kasturi Das, MD for her assistance with the cytopathologic interpretation of these cases.

Compliance with ethical standards

Conflict of interest

The authors have nothing to disclose.

References

  1. 1.
    Tille JC, Reychler H, Hamoir M, Schmitz S, Weynand B. Schwannoma-like pleomorphic adenoma of the parotid. Rare Tumors. 2011;3(4):e40.CrossRefGoogle Scholar
  2. 2.
    Eveson JW, Cawson RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age, and sex distribution. J Pathol. 1985;146:51–8.CrossRefGoogle Scholar
  3. 3.
    Seifert G, Donath K, Schafer R. Lipomatous pleomorphic adenoma of the parotid gland. Classification of lipomatous tissue in salivary glands. Pathol Res Pract. 1999;195:247–52.CrossRefGoogle Scholar
  4. 4.
    Di Palma S. Carcinoma ex pleomorphic adenoma, with particular emphasis on early lesions. Head Neck Pathol. 2013;7(suppl 1):S68–76.CrossRefGoogle Scholar
  5. 5.
    Richmon JD, Wahl CE, Chia S. Coexisting facial nerve schwannoma and monomorphic adenoma of the parotid gland. Ear Nose Throat J. 2004;83(3):166–9.Google Scholar
  6. 6.
    Gross B, Carlson M, Moore E. The intraparotid facial nerve schwannoma: a diagnostic and management conundrum. Am J Otolaryngol. 2012;33(5):497–504.CrossRefGoogle Scholar
  7. 7.
    Kim YC, Park HJ, Cinn YW, Vandersteen DP. Benign glandular schwannoma. Br J Dermatol. 2001;145(5):834–7.CrossRefGoogle Scholar
  8. 8.
    Ducatman B, Scheithaur B. Malignant peripheral nerve sheath tumors with divergent differentiation. Cancer. 1984;54:1049.CrossRefGoogle Scholar
  9. 9.
    Tarjan G. Schwannoma including epithelial elements mimicking pleomorphic adenoma of the submandibular gland on fine-needle cytology: the first case report. Diagn Cytopathol. 2015;43:395.CrossRefGoogle Scholar
  10. 10.
    Holliday AC, Mazloom SE, Coman GC, Kolodney MS, Chavan RN, Grider DJ. Benign glandular schwannoma with ancient change. Am J Dermatopathol. 2016.  https://doi.org/10.1097/DAD.0000000000000739.Google Scholar
  11. 11.
    Kapila K, Mathur S, Verma K. Schwannomas: a pitfall in the diagnosis of pleomorphic adenomas on fine-needle aspiration cytology. Diagn Cytopathol. 2002;27(1):53–9.CrossRefGoogle Scholar
  12. 12.
    Takeda Y, Shimono M. Pleomorphic adenoma with nuclear palisading of modified myoepithelial cells: histopathologic and immunohistochemical study. Bull Tokyo Dent Coll. 1999;40(1):27–34.CrossRefGoogle Scholar
  13. 13.
    Rossi ED, Faquin WC, Baloch Z, et al. The Milan System for Reporting Salivary Gland Cytopathology: analysis and suggestions of initial survey. Cancer Cytopathol. 2017;125:757–66.CrossRefGoogle Scholar
  14. 14.
    Chandra SR, Karim F, Yeshwant BR. Divergent schwannoma-like phenotype in a pleomorphic adenoma. Head Neck Pathol. 2017;11(4):567–74.CrossRefGoogle Scholar
  15. 15.
    Matsuyama A, Hisaoka M, Hasimoto H. PLAG1 expression in mesenchymal tumors: an immunohistochemical study with special emphasis on the pathogenetical distinction between soft tissue myoepithelioma and pleomorphic adenoma of the salivary gland. Pathol Int. 2012;62(1):1–7.CrossRefGoogle Scholar
  16. 16.
    Merino MJ, LiVolsi VA. Pleomorphic adenomas of the parotid gland resembling mesenchymal tumors. Oral Surg Oral Med Oral Pathol. 1977;44(3):405–10.CrossRefGoogle Scholar
  17. 17.
    Kajor M, Gierek T, Markowski J, Pajak J. Schwannomalike mixed tumor of the parotid gland: a case report. Acta Cytol. 2006;50(5):529–30.CrossRefGoogle Scholar
  18. 18.
    Lombardi M, Socciarelli F, Finin G, Leonardi A, Bartolazzi A. Schwannoma-like pleomorphic adenoma: a case report with review of the literature. Head Neck Pathol. 2014;8(2):178–81.CrossRefGoogle Scholar
  19. 19.
    Jo VY, Fletcher CD. p63 immunohistochemical staining is limited in soft tissue tumors. Am J Clin Pathol. 2011;136(5):762–6.CrossRefGoogle Scholar
  20. 20.
    Fehlings MG, Nater A, Zamorano JJ, Tetreault LA, Varga PP, Gokaslan ZL, et al. Risk factors for recurrence of surgically treated conventional spinal schwannomas: analysis of 169 patients from a multicenter international database. Spine. 2016;41(5):390–8.  https://doi.org/10.1097/BRS.0000000000001232.CrossRefGoogle Scholar
  21. 21.
    Zernial O, Springer IN, Warnke P, et al. Long-term recurrence rate of pleomorphic adenoma and postoperative facial nerve paresis (in parotid surgery). J Craniomaxillofac Surg. 2007;35:189–92.CrossRefGoogle Scholar
  22. 22.
    Abe M, et al. A case of pleomorphic adenoma of the parotid gland with multiple local recurrences through facial to cervical regions. Open J Stomatol. 2014;4:441–5.CrossRefGoogle Scholar
  23. 23.
    Redaelli de Zinis LO, Piccioni M, Antonelli AR, Nicolai P. Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature. Eur Arch Otorhinolaryngol. 2007;265(4):447–52.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Oral Pathology, Department of Dental Medicine, Long Island Jewish Medical CenterDonald and Barbara Zucker School of Medicine at Hofstra/Northwell HealthHyde ParkUSA
  2. 2.Department of PathologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  3. 3.Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical CenterDonald and Barbara Zucker School of Medicine at Hofstra/Northwell HealthNew Hyde ParkUSA
  4. 4.Division of Head and Neck Surgery, Department of Otolaryngology, Long Island Jewish Medical CenterDonald and Barbara Zucker School of Medicine at Hofstra/Norhtwell HealthNew Hyde ParkUSA

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