Schwannoma in Soft Palate: A Rare Case Report with Review of Literature
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CLINICAL REPORT
Schwannoma in Soft Palate: A Rare Case Report with Review of Literature Chiranjib Das1
•
Kaushik Dey2 • Sudip Kumar Das3
Received: 14 September 2020 / Accepted: 16 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Schwannoma is a benign tumor originating from Schwann cells of the nerve sheath. Approximately 25–45% of the schwannomas are seen in the head and neck region and are found rarely in the oral cavity (only 1%). The most common intra-oral site is tongue, followed by floor of the mouth, buccal mucosa, palate, gingiva and lips. We report a rare case of schwannoma in the soft palate in a 22 years old female. She presented with 6 months history of a painless swelling in palate. The provisional diagnosis was made as some benign neoplasm of minor salivary gland. The tumour was excised intra-orally under general anesthesia. Histopathologic examination showed neural tissue arranged in predominantly Antoni A pattern and formation of verocay bodies. It is difficult to diagnose this tumor based on clinical appearance. Therefore final diagnosis can only be done after histopathological examination of the lesion. Prognosis is good and recurrence is unknown. Keywords Schwannoma Soft palate Antoni A and B pattern Verocay bodies
& Chiranjib Das [email protected] 1
Department of ENT, Coochbehar Government Medical College and Hospital, Cooch Behar, West Bengal, India
2
Metropolis Healthcare Pvt Ltd, Kolkata, West Bengal, India
3
Department of ENT, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Introduction Schwannoma is a benign tumor originating from Schwann cells of the nerve sheath. [1] Approximately 25–45% of the schwannomas are seen in the head and neck region and are found rarely in the oral cavity (only 1%). [2] The most common intraoral site is tongue, followed by floor of the mouth, buccal mucosa, palate, gingiva and lips. [3] Clinically, these benign tumors are easily mistaken for other entities such as mucous retention cyst, lipoma, fibroma and minor salivary gland tumours. [4] The aim of this case report is to present a schwannoma of soft palate which is an unusual location for this tumour.
Case Report A 22 years old female patient presented to ENT OPD of a tertiary care hospital of West Bengal with an asymptomatic, single, slowly increasing swelling in the right side of soft palate for 6 months. Clinical examination revealed a sessile, rubbery, non-tender, non-ulcerated mass measuring approximately 2.5 cm 9 2.5 cm on the right side of soft palate (Fig. 1). Mucosa over the swelling was similar in colour and texture with surrounding mucosa. There was no palpable cervical lymph node. Computed tomography scan was made which showed soft tissue lesion in the right side of soft plate (Fig. 2). From these data, the provisional diagnosis was made as some benign neoplasm of minor salivary gland. The tumour was excised in toto intra-orally in tonsillectomy position under general anesthesia (Fig. 3) and the specimen (Fig. 4) was sent for histopathological
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