Malignant schwannoma of the palate: A case report and review of the literature

Abstract

The malignant schwannoma is an uncommon neoplasm of the head and neck region, and its presentation in the oral cavity is quite rare. Malignant schwannoma of the head and neck region represents approximately 8% to 16% of the total body distribution of this turnor.lA It can either arise independently or result from malignant change in a preexisting neurofibroma. Multiple neurofibromas, characteristic of von Recklinghausen’s disease, will demonstrate malignant change in 8% to 10% of patients. ‘J Malignant degeneration of a benign schwannoma is rare and conceptually controversial; Toriumi et al’ have noted only four adequately documented cases of such a transformation. The discussion of peripheral nerve tumors is complicated by the fact that there is disagreement over the histogenesis of these tumors and a lack of universally accepted terminology. Although there exists some debate6-9 most authors1,3,5~10,” currently believe that the Schwann cell is the precursor of the neurofibroma, schwannoma, and malignant schwannoma. A review of the literature regarding peripheral nerve sheath tumors reveals a multitude of terms for apparently similar lesions. Piatelli et al” found up to 19 terms (Table 1) for the malignant form of the schwannoma; for the sake of clarity, the term malignant schwannoma will be used in this report. Taking into account the previous literature reviews of Eversole et a127 and Martinez and Robinson6 there exist a total of 34 documented cases