J Korean Assoc Oral Maxillofac Surg.  2011 Dec;37(6):530-534. 10.5125/jkaoms.2011.37.6.530.

Ancient schwannoma in oral cavity: a report of two cases

• Kim NR
• Chung DH
• Park DS
• Kim DW
• Lee SC
• Kim SY
• Lim HY
• Yeom HY
• Kim HM

• KMID: 2136993
• DOI: http://doi.org/10.5125/jkaoms.2011.37.6.530

Abstract

This paper reports two cases of schwannomas arising from the oral cavity. One is an intraoral ancient schwannoma located at the left cheek, which evolved over a period of 13 years. The tumor was a well-demarcated buccal mass, which was located in the left lower first premolar area, with an obliterated the buccal vestibule, leaving the overlying mucosa intact. The second case was a central intraosseous schwannoma located from the left lower 1st molar periapical area to the left 3rd molar periapical area. Pathologically, the first mass was composed of the spindle shaped tumor cells with wavy nuclei beneath the fibroconnective tissue of the gingiva but second case mass was not. Occasional nuclear pleomorphism was observed but mitosis or necrosis was absent. There were Antoni A and B areas along with strong, diffuse staining with the S-100 protein. Ancient schwannomas were diagnosed. Schwannoma is a slow-growing benign tumor, and an ancient schwannoma that shows cellular atypism is a variant of a schwannoma caused by purely degenerative changes. To date, only limited cases of ancient schwannomas in the oral cavity have been reported.

Keyword

Neurilemmoma; Mouth; S100 proteins

MeSH Terms

Bicuspid
Cheek
Gingiva
Mitosis
Molar
Mouth
Mucous Membrane
Necrosis
Neurilemmoma
S100 Proteins
S100 Proteins

Figure

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  Fig. 1. Axial (A) and coronal (B) computed tomography of Case 1 reveals an ill defined lesion at the left mandibular body (arrows). Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 2. The well circumscribed protruding mass over the first premolar area near the mental foramen is seen in Case 1. Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 3. A. The relatively well marginated mass consists of spindle shaped tumor cells with buckling nuclei (H & E staining, ×40). B. The mass comprises the Antoni A area with the nuclear palisading patterns forming occasional Verocay bodies (arrow). Note the paucicellular myxoid Antoni B area (left upper portion, H & E staining, ×200). Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 4. Panoramic view of Case 2 showed well-defined homogeneous low density about 3.0×1.5×2.0 cm-sized cystic mass which is including inferior alveolar nerve in left mandible body. Left lower 1st molar distal root and 2nd molar root were resorption state. Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 5. A well-defined homogenous low density cystic mass in left mandible body. Definite root resorptions of molars were seen in left mandible. Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 6. The biopsied specimen is composed of spindle cells with twisted nuclei (H & E staining, ×100). Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011Na Rae Kim et al: Ancient schwannoma in oral cavity: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2011

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