Abstract
Schwannoma or neurilemmoma is a benign encapsulated slow-growing tumor that originates from a Schwann cell of a nerve, and is rare at intraoral locations. Different histological variants of schwannomas have been described, of these degenerative or ancient schwannoma is probably one of the least common in the oral cavity with only 16 previously reported cases, of which only one has been described in palatal location. Although ancient schwannoma shows particular characteristics, it is difficult to diagnose based on clinical and imaging appearance alone; as a result, morphological examination assisted by ancillary techniques is necessary to establish a definite diagnosis. We present a clinicopathological description of this rare variant of schwannoma, located in an unusual intraoral site, of a 26-year-old female. We illustrate the optical, immunohistochemical and ultrastructural characterization that aid diagnosis, as well as providing a review of the relevant published data of this unusual tumor.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Weiss SW, Goldblum JR (eds) (2001) Enzinger and Weiss’s soft tissue tumor, 4th edn. Mosby, St. Louis
Gainza-Cirauqui ML, Eguía-Del Valle A, Martínez-Conde R, Coca-Meneses JC, Aguirre-Urizar JM (2013) Ancient Schwannoma of the hard palate. An uncommon case report and review. J Clin Exp Dent 5(1):e62-5
Eversole LR, Howell RM (1971) Ancient neurilemmoma of the oral cavity. Oral Surg Oral Med Oral Pathol 32:440–443
Marks RK, Carr RF, Kreller AJ III (1976) Ancient neurilemmoma of the floor of the mouth: report of a case. J Oral Surg 34:731–735
McCoy JM, Mincer HH, Turner JE (1983) Intraoral ancient neurilemmoma (ancient schwannoma). Report of a case with histologic and electron microscopic studies. Oral Surg Oral Med Oral Pathol 56:174–184
Dayan D, Buchner A, Hirschber A (1989) Ancient neurilemmoma (schwannoma) of the oral cavity. J Craniomaxillofac Surg 17:280–282
Nakayama H, Gobara R, Shimamoto F, Kajihara H (1996) Ancient schwannoma of the oral floor and ventricular portion of the tongue: a case report and review of the literature. Jpn J Clin Oncol 26:185–188
Ledesma C, Portilla J, Hernández F, Garces M, Hernandez JC (1999) Paraglandular ancient schwannoma. Med Oral 4:398–402
Chen CY, Wang WC, Chen CH, Chen YK, Lin LM (2006) Ancient schwannoma of the floor of the mouth. A case report and review. Oral Oncol 42:281–285
Subhashraj K, Balanand S, Pajaniammalle S (2009) Ancient schwannoma arising from mental nerve. A case report and review. Med Oral Patol Oral Cir Bucal 14:12 – 4
Humber CC, Copete MA, Hohn FI (2011) Ancient schwannoma of upper lip: case report with distinct histologic features and review of the literature. J Oral Maxillofac Surg 69:e118-22
Kim NR, Chung DH, Park DS, Kim DW, Lee SC, Kim SY, Lim HY, Yeom HY, Kim HM (2011) Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 37:530–534
Amirchaghmaghi M, Salehinejad J, Basirat M, Delaviran A, Javadzade A, Forouzanfar A (2010) Gingival ancient schwannoma: review of literature and a case report. J Appl Sci 10:3137–3140
Zehlicke T, Lessle M, Graner L (2006) The ancient schwannoma. A rare tumor of the mouth floor. HNO 54: 307–311
Tobita T, Ikeda H, Fujita S, Ikeda M, Ohba S, Shibahara K (2008) Ancient schwannoma in the buccal region. Asian J Oral Maxillofacial Surg 20:139–143
Bilici S, Akpinar M, Yigit Ö, Günver F (2011) Ancient schwannoma of the tongue: a case report. Kulak Burun Bogaz Ihtis Derg 21:234–236
Vera Sempere FJ, Vera-Sirera B (2010) Intraosseus plexiform schwannoma of the mandible. Immunohistochemical differential diagnosis. J Craniofac Surg 21:1280–1284
Ackerman LV, Taylor FH (1951) Neurogeneous tumors within the thorax; a clinicopathological evaluation of forty-eight cases. Cancer 4:669–691
Papiez J, Rojiani MV, Rojiani AM (2014) Vascular alterations in schwannomas. Int J Clin Exp Pathol 7:4032–4038
Jaiswal S, Agrawal V, Jaiswal AK, Pandey R, Mahapatra AK (2009) Expression of estrogen and progesterone receptors in vestibular schwannoma and their clinical significance. J Negat Results Biomed 8:9
Jones HM, Conces DJ Jr, Tarver RD (1993) Painful transthoracic needle biopsy: a sign of neurogenic tumor. J Thorac Imaging 8:230–232
Chu YC, Yoon YH, Han HS, Han JY, Kim JM, Park IS (2003) Malignant transformation of intrathoracic ancient neurilemmoma in a patient without von Recklinghausen’s disease. J Korean Med Sci 18:295–298
Chrysomali E, Papnicolaou SI, Dekker NP, Regezi JA (1997) Benign neural tumors of the oral cavity. A comparative immunohistochemical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84:381–390
Huang HY, Park N, Erlandson RA, Antonescu CR (2004) Immunohistochemical and ultrastructural comparative study of external lamina structure in 31 cases of cellular, classic and melanotic schwannoma. Appl Immunohistochem Mol Morphol 12:50–58
Luse SA (1966) Electron microscopy studies of brain tumors. Neurology 10:881–905
Min KW (2005) Stromal elements for tumor diagnosis: a brief review of diagnostic electron microscopic features. Ultrastruct Pathol 29:305–318
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Financial support
The authors of this article declare that they have not received any funding source for the design and realization of this study.
Conflict of interest
The authors declare no conflict of interests.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Vera-Sirera, B., Fernades-Ciacha, L., Floria, L.M. et al. Palatal ancient schwannoma: optical, immunohistochemical and ultrastructural study with literature review. Eur Arch Otorhinolaryngol 274, 4195–4202 (2017). https://doi.org/10.1007/s00405-017-4759-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-017-4759-5