Intra-osseous Schwannoma of Mandibular Symphysis: A Rare Case Presentation

Priyankar Singh *

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

Jawed Iqbal

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

Aakanksha Sharma

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

Swati Singh

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

Nimmi Singh

Nimmi Singh Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

Navin Mishra

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

A. K. Sharma

Department of Cranio-Maxillo-Facial Surgery, Indira Gandhi Institute of Medical Sciences, Patna, India.

*Author to whom correspondence should be addressed.


Abstract

Aim: To describe a rare presentation of intra-osseous schwannoma of mandible.

Presentation of Case: A rare representation of diffuse non-tender swelling at parasymphysis of mandible with bicortical expansion and negative aspiration on FNAC. A complete wide surgical enucleation of soft, doughy mass was done through intra-oral papilla preservating flap followed by suitable dissection preserving the vital nerves and vessels in the vicinity was done. Histopathologically the tissue tumor mass arranged in Antoni A pattern showing Verocay bodies formed by streaming fascicles of spindle shaped schwann cells forming palisade arrangement around central acellular, eosinophic areas.

Discussion: Neurilemmomas is a typical histopathological finding with typical histological features includes Antoni A areas, Antoni B areas, or both. Antoni A regions have high cellularity and are composed of densely packed spindle cells arranged in palisades. On the other hand, Antoni B regions have more myxoid structures and two palisading rows of aligned nuclei in an eosinophil zone.

Conclusion: Intraosseous lesions located in the peripheral region with non-specific clinical and radiographic features often lead to diagnostic confusion. Most of the lesions located in the environs of the teeth are odontogenic in origin. Yet, other possibilities like intraosseous scwhannomas must be considered.

Keywords: Intra-osseous, schwannoma, mandible


How to Cite

Singh , P., Iqbal , J., Sharma , A., Singh, S., Singh , N., Mishra , N., & Sharma , A. K. (2023). Intra-osseous Schwannoma of Mandibular Symphysis: A Rare Case Presentation. International Journal of Research and Reports in Dentistry, 6(2), 112–116. Retrieved from https://journalijrrd.com/index.php/IJRRD/article/view/165


References

Swami P, Raval R, Kumawat V, Nyklesh V. Maxillary schwannoma a case report of a rare tumor. Natl J Maxillofac Surg. 2019; 10(2):245-248.

Yosuke Harazono, Kou Kayamori, Junichiro Sakamoto, et al. Retrospective analysis of schwannoma in the oral and maxillofacial reclinicopathological characteristics and specific pathology of ancient change. 2022;60(3):326-331.

Ahlawat S, Blakeley JO, Langmead S, Belzberg AJ, Fayad LM. Current status and recommendations for imaging in neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. Skeletal Radiol. 2020; 49(2):199-219.

Vera-Sirera B, Fernades-Ciacha L, Floria LM, Vera-Sempere F. Palatal ancient schwannoma: optical, immunohistochemical and ultrastructural study with literature review. Eur Arch Otorhinolaryngol. 2017;274(12):4195- 202.

Butler RT, Patel RM, McHugh JB. Head and neck Schwannomas: 20-year experience of a single institution excluding cutaneous and acoustic sites. Head Neck Pathol. 2016;10(3):286-91.

Salehinejad J, Sahebnasagh Z, Saghafi S, Sahebnasagh Z, Amiri N. Intraoral ancient schwannoma: A systematic review of the case reports. Dent Res J (Isfahan). 2017; 14(2):87- 96.

Goldblum JR, Folpe AL, Weiss SW, Enzinger FM. Enzinger & Weiss's soft tissue tumors. 7th Ed: Elsevier; 2020;9: 1294.

Harhar M, Ramdani A, Bouhout T, Serji B, El Harroudi T. Retroperitoneal schwannoma: two rare case reports. Cureus. 2021;13(2):e13456. DOI: 10.7759/cureus.13456. PMID: 33777545

Mohan A, Kadani M, Nalamolu B, Srilatha T, Kakati I. Maxillary Schwannoma – A rare case report. Oral Maxillofac Pathol J. 2022;13(2):179-182.

Fechner RE, Mills SE. Miscellaneous mesenchymal lesions. In: Tumors of the bones and joints. Washington, DC: American Registry of Pathology; 2002; 206.