Ancient schwannoma of the infratemporal fossa

Abstract

Schwannomas are benign tumors of neurogenic origin arising from the Schwann cells of peripheral, cranial, and autonomic nerves. Schwannomas in spite of constituting 25-40% of head and neck tumors the percentage of intraoral schwannomas is merely 1%. Among the intraoral schwannoma the occurrence of the variant “ancient schwannoma of the infratemporal fossa with an intraoral presentation is very rare. The purpose of this presentation is to highlight the rarity of this lesion, to stress the importance of an accurate diagnosis and to consider neurogenic lesions in the differential diagnosis of head and neck lesions.

An Unusual Variant of Cerebellopontine Angle Schwannoma in a Young Nepalese Girl

“…They alone constitute 25-40% of head and neck tumors [2]. Several cases of extracranial ancient schwannoma have been reported in English literature [2][3][4][5]. However an ancient variant involving CPA is particularly rare and our case presentation is one of them.…”

“…Ancient schwannoma is notorious for cellular pleomorphism which is a prominent pathological feature and the pathologist may have a misleading report on histological examination [11]. The presence of either fatty or cystic degeneration with foci of hyaline material, thick capsule, infiltration of histiocytes siderophages and hyperchromatism attributed to the long duration of the Schwannomas [4]. Nuclear atypia, xanthomatous change, and fibrosis are additional histopathological findings.…”

A rare report of two cases: Ancient schwannoma of infratemporal fossa and verocay schwannoma of buccal mucosa

“…[ 9 ] Ancient schwannoma usually present as submucosal swellings with a higher female predilection. [ 4 ] The presenting lesion can be a primary in the infratemporal fossa with extension into the oral cavity or vice versa. Similar finding was present in our report, where primary site was buccal mucosa in the first case and imfratemporal fossa in the second case.…”

“…These histopathological features were attributed to the long duration of the schwannoma as consistent with the second case. [ 4 ]…”

“…[ 3 ] The infratemporal fossa is one of the least common anatomical sites for schwannomas. [ 4 ] The tumor can arise at any age but is most common in the third and fourth decades of life. [ 5 ] It is not certain whether there is a predilection for men, women or it is equally distributed between sexes.…”