scholarly journals Sublingual Schwannoma: A Rare Clinical Entity reported in a Hypothyroid Female

2012 ◽  
Vol 3 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Sudhir Naik ◽  
S Ravishankara ◽  
Mohan K Appaji ◽  
MK Goutham

ABSTRACT Background Schwannomas are solitary, encapsulated tumor usually attached to, or surrounded by a nerve and are not associated with von Recklinghausen's disease and rarely show malignant degeneration. Setting Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia. Case report A 68-year-old female presented with pain at the left side of the tongue since 1 month. Also a firm to soft 7 × 5 cm sublingual swelling of long-standing duration was seen. FNAC was inconclusive and contrast CT showed a sublingual swelling with mild-contrast enhancement. Intervention Sublingual excision of the tumor was done under general anesthesia and the tumor enucleated. No complications were seen and the recovery was uneventful. Histopathological report came as benign schwannoma and immunoreactive to S- 100 protein. Conclusion Most of the intraoral schwannomas are managed by complete surgical excision and recurrence are not reported. Malignant transformation is not seen in any of the intraoral schwannomas but definite preoperative diagnosis is necessary to avoid wide excision when the tumors can be easily enucleated without recurrence. How to cite this article Naik SM, Goutham MK, Ravishankara S, Appaji MK. Sublingual Schwannoma: A Rare Clinical Entity reported in a Hypothyroid Female. Int J Head and Neck Surg 2012;3(1):33-39.

1980 ◽  
Vol 89 (1) ◽  
pp. 72-74 ◽  
Author(s):  
Richard E. Goodwin ◽  
George H. Fisher

Four representative cases of keratoacanthoma of the head and neck are presented; one of which contained squamous cell carcinoma at its base. Although keratoacanthoma has become recognized as a distinct clinical entity, its similarities to squamous cell carcinoma frequently result in difficult diagnosis. A discussion of the disease spectrum, diagnosis and management is presented. Prompt and complete surgical excision of head and neck keratoacanthoma is recommended.


Author(s):  
Nithya J. ◽  
Banumathy M. ◽  
Radha A.

Solitary nerve sheath tumor such as Benign schwannomas arising in the pelvic retro peritoneum is infrequently reported. Retroperitoneal location accounts for 0.3-3.2% of primary schwannomas. We report a case of benign retroperitoneal pelvic schwannoma in pregnancy that was incidentally diagnosed when it presented with Preterm premature rupture of membranes and mechanical obstruction for labour. She underwent caesarean section and delivered a healthy baby. She was evaluated in the postoperative period by computerized tomography (CT) imaging studies and CT guided fine needle aspiration cytology (FNAC) was not diagnostic. Complete surgical excision of the tumor was achieved in the postpartum period. The adjacent vascular and urinary channels sustained no injuries and she had no neurologic deficit. Histology revealed spindle cell neoplasm composed of interlacing fascicles and sheets of spindle cell with focal areas of nuclear palisading and thick walled blood vessels. Immunohistochemistry was positive for S 100 suggesting schwannoma. Retroperitoneal location of schwannomas is rare and surgery is curative. Prognosis is good, since recurrence is rare. 


Author(s):  
Chandra Veer Singh ◽  
Sheetal Radia ◽  
Saalim Sheikh ◽  
Vijay Haribhakti

<p class="abstract">Schwannoma are slow growing tumours, which can arise from any peripheral nerve. 10% of schwannomas that occur in the head and neck region mostly originate from the vagus or sympathetic nervous system. Extracranial schwannomas in the head and neck region are rare neoplasm. Intraoral schwannoma are only 1% of the all head and neck tumours. Diagnosis is established by imaging studies such as magnetic resonance imaging or computed tomography, while FNAC is used to rule out other conditions. We report a rare case of lingual schwannomas generally present as a painless lump schwannoma of the tongue in a 27-year-old male complaining of asymptomatic swelling over a posterolateral surface of the tongue, treated by complete surgical excision. The diagnosis was established on the basis of clinical, histopathological, and immunohistochemical examination. We report a rare case of schwannoma over the posterolateral surface of tongue. Prognosis is good for the patient when this condition is correctly diagnosed as the condition rarely recurs after complete resection.</p>


2020 ◽  
Author(s):  
Srinjoy Saha

Abstract Schwannomas are rare tumours arising from peripheral nerve sheath and are usually related to the spinal cord and spinal nerves. Contrast magnetic resonance imaging (MRI) usually helps in establishing a pre-operative diagnosis. Rarely, their manifestation may be surprisingly new. Here, a 44-year-old lady came to our clinic with a painless asymptomatic progressively enlarging swelling over her upper back. It was fluctuant, with absent neural signs and symptoms. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling near the upper thoracic vertebrae. However, classical diagnostic signs of schwannoma were absent. Complete surgical excision was performed with smooth dissection through a well-defined plane between the lesion and surrounding muscles. A 6.5x5.0x2.5 cm oval lesion with a glistening whitish-grey capsule was excised, and the deep wound was reconstructed in multiple layers. Interestingly, it was not attached to any identifiable nerves. Histopathology showed typical hallmarks like Antoni A regions and Verocay bodies. Positive S-100 staining during immunohistochemistry established its diagnosis as schwannoma. The postoperative one-and-half-year follow-up period was uneventful. Cystic schwannomas can surprise and confuse clinicians by arising anywhere in the body and with atypical manifestations. Surgeons need to consider it in the differential diagnoses of any undiagnosed slowly-growing swelling, including purely-cystic ones and perform careful surgical dissection to avoid any inadvertent nerve damage.


Author(s):  
Harshad Nikte ◽  
Nitish Virmani ◽  
Jyoti Dabholkar

Cervical root schwannoma is an infrequent benign peripheral nerve tumor though those arising from high cervical spinal root are common amongst the spinal schwannomas. This mass commonly presents as a slow growing, asymptomatic, solitary neck mass with rare potential of   malignant degeneration. Displacement of Internal jugular vein and carotids anteriorly is frequently seen though abutment of esophagus is uncommon. Pre operative diagnosis can be established with imaging and Fine needle aspiration cytology (FNAC). Complete Surgical excision is the treatment of choice. Horner’s syndrome is the most common post operative neurological manifestation. Here we have recorded clinical features intra-operative findings and surgical histopathology. We have described a case of 19 year old male with cellular schwannoma of cervical sympathetic chain with intraspinal extension and arising from C5-C8 level. Another case of cervical root schwannoma is described in a 5 year old girl arising at C4-C5 level. Complete surgical excision was done for both patients with no postoperative neurological affection. The clinico-pathological evaluation and management are described


2020 ◽  
Author(s):  
Srinjoy Saha

Abstract Schwannomas are rare tumours arising from peripheral nerve sheath. Here, a 44-year-old lady came to our clinic with an asymptomatic progressively-enlarging swelling over her upper back. It was fluctuant, with an absence of pain and tenderness. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling nearby upper thoracic vertebrae. Complete surgical excision proceeded smoothly through a well-defined plane between the swelling and the muscles. It was not attached to any identifiable nerve. A 6.5x5.0x2.5 cm ovoid lesion with a glistening whitish-grey capsule was excised and wound reconstructed in layers. Histopathology showed hypercellular areas with nuclear palisading or oval-shaped Verocay bodies. Only S-100 tested positive amongst the five-antigen immunohistochemistry, thus establishing the diagnosis of a schwannoma. Postoperatively, a one-year follow-up period was uneventful. Schwannomas can surprise clinicians by arising anywhere and with atypical presentations. It needs to be in the differential diagnoses of any asymptomatic slowly-growing lesion.


2020 ◽  
Author(s):  
Danni Cheng ◽  
Yufang Rao ◽  
Ke Qiu ◽  
Jianqing Qiu ◽  
Yijun Dong ◽  
...  

Abstract Background and Objectives: Carcinomas derived from myoepithelial cells in head and neck regions (CMCHN) are rare. The aim of this study was to demonstrate the clinical behaviors and treatment outcomes of these tumors.Methods: A retrospective review of fifteen CMCHN cases between 2002 and 2019 in a single institution was performed. Results: All of the fifteen patients (100%) underwent primary surgical resection. Eleven patients (73.3%) received conventional postoperative radiotherapy and four (26.7%) received systemic chemotherapy. Consequently, six patients (40%) had frequently recurrence after surgical resection, and seven patients (46.7%) received second or even third operations. Up to the time of last follow-up, only one patient died and the mean survival time was 15.8 years.Conclusions: Currently, complete surgical excision with or without systemic therapy is preferred, but it has limited efficacy on reducing the risk of recurrence. Thus, more effective systemic therapies are required and the researches on the mechanism of CMCHN recurrence should be encouraged.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E O'Beirn ◽  
J Elliott ◽  
C Neary ◽  
R McLaughlin

Abstract Introduction An arteriovenous malformation (AVM) is defined as an abnormal connection between arteries and veins, bypassing the capillary system. AVM of the breast is a rare clinical entity, with limited evidence to guide management. We present the case of a congenital AVM of the breast in an otherwise healthy woman, with an interesting presenting complaint. Case Description A 38-year-old female presented with a ‘buzzing’ sensation and mastalgia in her left breast. Examination revealed a visible pulsatile linear abnormality with a bruit on auscultation. Duplex ultrasonography demonstrated mixing of the arterial and venous flow, consistent with an AVM. Operative management entailed ultrasound guided identification, ligation and excision of all aneurysmal segments. Histopathologic evaluation demonstrated an AVM with no malignant features. At one year postoperatively, the patient reported complete symptom resolution. Literature review identified nine case reports, including two cases of congenital breast AVM, both treated surgically. Seven cases of iatrogenic AVM were identified, with diagnosis based on duplex ultrasonography and management by surgical ligation in all except one, which resolved spontaneously. Conclusions ongenital AVM of the breast is a rare clinical entity. Diagnosis can be established using duplex ultrasonography, while CT and MRI may be useful for preoperative planning. Endovascular management alone is associated with high recurrence rates and surgical excision is the favoured approach where technically feasible without major aesthetic or functional compromise.


2020 ◽  
Vol 3 (3) ◽  
pp. 103-106
Author(s):  
Srinjoy Saha

Schwannomas are rare tumours arising from peripheral nerve sheath and are usually related to the spinal cord and spinal nerves. Contrast magnetic resonance imaging (MRI) usually helps in establishing a pre-operative diagnosis. Rarely, their manifestation may be surprisingly new. Here, a 44-year-old lady came to our clinic with a painless asymptomatic progressively enlarging swelling over her upper back. It was fluctuant, with absent neural signs and symptoms. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling near the upper thoracic vertebrae. However, classical diagnostic signs of schwannoma were absent. Complete surgical excision was performed with smooth dissection through a well-defined plane between the lesion and surrounding muscles. A 6.5x5.0x2.5 cm oval lesion with a glistening whitish-grey capsule was excised, and the deep wound was reconstructed in multiple layers. Interestingly, it was not attached to any identifiable nerves. Histopathology showed typical hallmarks like Antoni A regions and Verocay bodies. Positive S-100 staining during immunohistochemistry established its diagnosis as schwannoma. The postoperative one-and-half-year follow-up period was uneventful. Cystic schwannomas can surprise and confuse clinicians by arising anywhere in the body and with atypical manifestations. Surgeons need to consider it in the differential diagnoses of any undiagnosed slowly-growing swelling, including purely-cystic ones and perform careful surgical dissection to avoid any inadvertent nerve damage.


Author(s):  
T. J. Phillips ◽  
B. N. Harris ◽  
M. G. Moore ◽  
D. G. Farwell ◽  
A. F. Bewley

Abstract Objective The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4–6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival. Study design Retrospective database review. Setting All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California. Subjects and methods The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances. Results Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034). Conclusion The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients.


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