Case Report: Schwannoma of the tongue

Abstract

Schwannomas are benign neoplasms originating from Schwann cells of the peripheral nerve sheath. Intraoral lesions are uncommon. A 58-year-old female patient complained of discomfort at the apex of the tongue. Clinical examination revealed a fibrous, lobulated, delimited, and normochromatic nodular lesion, measuring 3 centimeters in diameter, with 10 years of evolution. Diagnostic hypotheses included schwannoma and neurofibroma, thus, an excisional biopsy was performed. Microscopic analysis showed a proliferation of fusiform cells organized in a more cellularized area, with a palisade arrangement around acellular areas, and a less cellularized area, with dispersed cells, intermingled with loose connective tissue. The neoplastic cells were positive for immunohistochemical reactions for S100, confirming the diagnosis of schwannoma. The patient remained without symptoms and with no signs of recurrence after 18 months of follow-up. The correlation of clinical signs and symptoms is essential for the elaboration of the differential diagnosis, treatment planning, and diagnosis confirmation. Schwannomas are benign neoplasms originating from Schwann cells of the peripheral nerve sheath. Intraoral lesions are uncommon. A 58-year-old female patient complained of discomfort at the apex of the tongue. Clinical examination revealed a fibrous, lobulated, delimited, and normochromatic nodular lesion, measuring 3 centimeters in diameter, with 10 years of evolution. Diagnostic hypotheses included schwannoma and neurofibroma, thus, an excisional biopsy was performed. Microscopic analysis showed a proliferation of fusiform cells organized in a more cellularized area, with a palisade arrangement around acellular areas, and a less cellularized area, with dispersed cells, intermingled with loose connective tissue. The neoplastic cells were positive for immunohistochemical reactions for S100, confirming the diagnosis of schwannoma. The patient remained without symptoms and with no signs of recurrence after 18 months of follow-up. The correlation of clinical signs and symptoms is essential for the elaboration of the differential diagnosis, treatment planning, and diagnosis confirmation.