Abstract
Schwannomas are tumors of the peripheral nerves originating in the nerve sheaths that account for 1% of benign tumors located in the oral cavity. The tongue as a whole is the most common location for intraoral schwannomas to occur; however, it is quite rare to diagnose schwannoma in children. We are contributing a report of a 13-year-old child with a 1-year history of slowly growing swelling on the anterior part of corpus of the tongue. The patient complained of the disturbance to mastication and phonation. Diagnosis was confirmed by excisional biopsy. Histologic identification of Antoni A and B areas along with strong and diffuse staining with S-100 stain pathologically completed the diagnosis of schwannoma.
1
Introduction
The schwannomas are nervous tissue tumors also known as neurilemomas . They are benign, slow growing, epineurium-encapsulated neoplasms arising from Schwann cells that comprise the myelin sheaths surrounding peripheral nerves . They are uncommon in peripheral nerves. Extracranially, about 25% of all schwannomas are located in the head and neck, but only 1% shows an intraoral origin. The intraoral lesions show a predilection for the tongue. The palate, buccal mucosa, lip, and gingiva are also affected in decreasing order . Although they may arise at any age, the peak incidence is between the third and sixth decades. There is no sex predilection . Here, we present a case of schwannoma that arose in the anterior part of the body of the tongue in a child.
2
Case report
A 13-year-old child without any significant medical history was referred to the Department of Otolaryngology at Haydarpasa Numune Education and Research Hospital (Istanbul, Turkey) for evaluation of a mass in the tongue. The tumor presented as a slowly growing mass producing few symptoms. Her symptoms included disturbance to mastication and a change in the quality of her voice.
During the oral examination, 20 × 15-mm mass on the anterior part of the tongue could be observed. It had semielastic consistency, is movable, causes pain when touched, and is covered by a nonulcerated mucosa. No radiologic investigations were needed because the mass was easily seen and palpable. The remainder of the oral examination was unremarkable. An excisional biopsy was done under general anesthesia by transoral approach. The entire lesion was removed completely from the tongue using blunt dissection ( Fig. 1 ). There were no perioperative and postoperative complications, and there was no need for nasogastric tube insertion postoperatively. Tissue was sent for histopathologic examination.
The histopathologic examination reveals a well-defined neoformation surrounded by fibrous connective tissue in a capsule-like form where remains of nerve endings could be observed, and it is at this point where the intramuscular neoformation made up of fusiform cells arranged in an intercrossed formation on top of a loose matrix ( Fig. 2 ). Two types of patterns can be observed with Antoni type B predominating over type A. There is no mitotic activity. The neoformation includes many hyalinized wall vessels. A confirmatory S-100 immunoperoxidase stain was strongly positive. The final diagnosis was a benign schwannoma. The patient has not shown any recurrence in the follow-up period of 1 year.
2
Case report
A 13-year-old child without any significant medical history was referred to the Department of Otolaryngology at Haydarpasa Numune Education and Research Hospital (Istanbul, Turkey) for evaluation of a mass in the tongue. The tumor presented as a slowly growing mass producing few symptoms. Her symptoms included disturbance to mastication and a change in the quality of her voice.
During the oral examination, 20 × 15-mm mass on the anterior part of the tongue could be observed. It had semielastic consistency, is movable, causes pain when touched, and is covered by a nonulcerated mucosa. No radiologic investigations were needed because the mass was easily seen and palpable. The remainder of the oral examination was unremarkable. An excisional biopsy was done under general anesthesia by transoral approach. The entire lesion was removed completely from the tongue using blunt dissection ( Fig. 1 ). There were no perioperative and postoperative complications, and there was no need for nasogastric tube insertion postoperatively. Tissue was sent for histopathologic examination.
