Tongue Schwannoma: A Clinicopathologic Study of 19 Cases
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ORIGINAL PAPER
Tongue Schwannoma: A Clinicopathologic Study of 19 Cases Lester D. R. Thompson1 · Stephen S. Koh2 · Sean K. Lau2 Received: 22 July 2019 / Accepted: 28 August 2019 © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019
Abstract Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely affect the tongue. The clinical and pathologic features of 19 cases of schwannoma arising in the tongue were analyzed. There were 13 males and 6 females ranging in age from 12 to 82 years (mean 34 years; median 29 years). The majority of tumors presented as an asymptomatic mass localized to the anterior two-thirds of the tongue. Histologically, 18 schwannomas exhibited characteristic Antoni A and B areas with the former pattern predominating. One tumor was composed exclusively of cellular Antoni A tissue and was classified as a cellular schwannoma. Tumor encapsulation was variable with nearly half of the lesions lacking a well-defined fibrous capsule. All were strongly and diffusely positive for S-100 protein. No recurrences were observed on clinical follow-up. Schwannoma of the tongue, although rare, should be separated from other types of lingual nerve sheath proliferations and tumors. Keywords Schwannoma · Peripheral nerve sheath neoplasm · Neurilemmoma · Tongue neoplasms · Tongue · Lingual · Oral cavity · S100 protein
Introduction Peripheral nerve sheath tumors commonly occur in the head and neck region but are rarely encountered in the oral cavity. The reported frequency of oral peripheral nerve sheath tumors among all lesions affecting the oral cavity is approximately 0.2%, the majority of which are neurofibromas [1–3]. Schwannomas seldomly involve the oral region. Among intraoral sites, the tongue is the most commonly affected location, but overall lingual examples of schwannoma remain infrequent [4–7]. Due to their rarity, the reported literature documenting schwannoma of the tongue is limited to small series and single case reports [7–11]. In this study, the clinical and pathologic characteristics of 19 cases of schwannoma of the tongue were evaluated. This represents
the largest series of this uncommon type of oral peripheral nerve sheath tumor to date.
Materials and Methods Nineteen cases of schwannoma involving the tongue were identified from the files of the Departments of Pathology, Southern California Permanente Medical Group. Hematoxylin and eosin stained slides from all cases and previously performed immunohistochemical studies were reviewed. Clinical data, treatment, and follow-up was obtained from electronic medical records augmented by the surgical pathology reports. This clinical investigation was conducted in accordance and compliance with all statutes, directives, and guidelines of an Internal Review Board authorization (#5968) performed under the direction of Southern California Permanente Medical Group.
* Lester D. R. Thompson [email protected] 1
Southern California Pe
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