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Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns. Ancient neurilemmomas are usually longstanding growths that exhibit degenerative features that could be mistaken for malignancy. They are extremely rare in the oral cavity and present in older individuals of long duration. The authors report a case of ancient neurilemmoma in a young patient with short duration of growth. This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change. It is essential to not mistake these features as malignant transformation so as to avoid radical procedures.

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