口底部に発現した神経しょうしゅの１例

Abstract

Schwannoma is an endodermal tumor originating in Schwann's cells of myelinated nerves and occurs in the gnathic oral cavity or relatively rate occasions. Schwannoma in the tongue has often been reported but occurrence in the buccal mucous membrane, palate or gingiva in the floor of the mouth is rare.We recently experienced a case of schwannoma in the floor of the mouth with the result described below.The patient, a 63-year-old woman, visited our hospital with a chief complaint of mass in the hypoglottis. She first felt a swelling in the hypoglottis about three months previously without any treatment thereafter because of the absence of pain. However, the patient visited a domestic hospital because she noticed that the mass was growing two weeks before coming to our hospital. She was diagnosed as having a dermotoid cyst and referred to us on December, 6, 1983. Intraoral examination revealed a diffuse tumoid rising in the right floor of the mouth. A walnut-sized mass with relatively clear bordering was palpable. It was elastic in consistency without tenderness. In addition, the mass was movable within the surrounding tissue.Under the clinical diagnosis of dermoid cyst, the tumor was removed under local anesthesia on December 15, 1983. The mass was covered with a thin capsule without adhesion to the surrounding tissue, so that it was easily resected en block. Thus removed mass was spherical, 15×17×12 mm in size, and covered with a capsule with smooth, grey-yellow surface and slightly low elasticity.Pathohistological examination revealed that the mass was a solid tumor covered with a thin capsule consisted of connective tissue, and bordered with interstitial tissue containing fi broblasts and collagenous fibers. In addition, tumor cells arranged and proliferated in a close bundle or palisade fashion, i.e. so called line of soldiers, in some parts, while they arranged in a network fashion in others. From these findings, the tumor was pathologically diagnosed as schwannoma (Antoni type A and B). This kind of tumor occurring in the mouth floor seemed very rare since it has less reported in the literature concerned.