J Korean Assoc Oral Maxillofac Surg.  2023 Jun;49(3):148-151. 10.5125/jkaoms.2023.49.3.148.

Buccal nerve schwannoma mimicking a salivary gland tumor: a rare case report

• Ku JK
• Han D
• Huh JK
• Kim JY

• KMID: 2544317
• DOI: http://doi.org/10.5125/jkaoms.2023.49.3.148

Abstract

Schwannomas are benign tumors originating from myelinating cells constituting nerve sheaths but rarely contain cellular elements of the nerve. The authors encountered a 47-year-old female patient with a schwannoma on the anterior mandibular ramus arising from the buccal nerve, measuring 3 cm×4 cm. Surgical resection was performed with preservation of the buccal nerve via microsurgical dissection. After one month, the sensory function of the buccal nerve was recovered without complications.

Keyword

Buccal nerve; Mandible; Pathology; Schwannoma

Figure

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  Fig. 1 Clinical images of schwannoma from the long buccal nerve. A. Swelling was noted on the anterior border of the ramus ascending branch. B. The long buccal nerve was detected from the middle portion of the tumor. C. The tumor was resected while preserving the long buccal nerve by dissecting it from the tumor.

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  Fig. 2 Preoperative images. A. Computed tomography revealed a homogeneous mass, slightly less dense than the adjacent muscles, and expansion of the ramus with some irregular resorption borders (arrow). B. T2-weighted magnetic resonance imaging showed a multifocal hypointense portion, but the long buccal nerve was not visualized clearly (arrow).

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  Fig. 3 Histopathology of the surgical specimen (H&E staining). A. The mass was composed of spindle cells with proliferated biphasic growth patterns and was surrounded by a well-formed fibrous capsule (arrows) (×100). Scale bar=200 µm. B. Compact cellular area, called an Antoni A area, showed characteristic nuclear palisading separated by fibrillary cell processes (×100). Scale bar=100 µm.

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  Fig. 4 Reconstructed three-dimensional images from preoperative computed tomography (left) and magnetic resonance imaging (MRI) (right). In the MRI view, the location of the long buccal nerve was suggested based on the intraoperative findings (arrow).

Reference

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