Intraosseous Schwannoma of the Mandible

Manjunath, V; Vasudevan, Vijeev; Nandakumar,; Srinath,; Bavle, Radhika M; Kailasam, S

doi:10.5005/jp-journals-10011-1041

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Such incomplete septa have been reported previously in computed tomography (CT) study of the same lesion which gave an impression of multilocularity in plain radiographs [10,11]. Some authors say multilocularity in the two-dimensional imaging modality might be due to the peripheral scalloping, that is, due to the shadowing of corrugations on the walls of the bone cavity containing the tumor [5,7,12]. Furthermore, distinct asymmetrical distension of the mandibular canal is considered to be a profound indicator of neural pathology [13] and a welldefined sclerotic border suggested benign nature [5].…”

Section: Discussionmentioning

confidence: 67%

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Ramesh¹,

Jayachandran²

2020

IJCR

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S chwannoma (neurilemmoma, neurinoma, or perineural fibroblastoma) is a benign tumor of Schwann cells, which forms the inner layer of nerve sheath (World Health Organization grade-I, International Classification of Diseases-O 9560/0). It is classified as Central schwannoma (intraosseous) and Peripheral schwannoma (in soft tissues). It is relatively common in the head and neck region (25%) [1,2]. Intraorally, it is rare (1-12%) with the tongue as the most predilected site. Intraosseous schwannomas are even rarer, <1% of primary bone tumors [2-5]. Here, we report a case with detailed cone-beam computed tomographic (CBCT) image findings of the intraosseous mandibular schwannoma of inferior alveolar nerve (IAN) and becomes first of its kind in the literature [2,6] to the best of our knowledge CASE REPORT An otherwise healthy 35-year-old female patient reported to our Department of Oral Medicine and Radiology with complaints of pain and swelling on the left side of the lower jaw for the past 6 months. There was a history of swelling which was gradual in onset and slow in progress, also associated with dull and continuous pain in the left body of the mandible region for the past 6 months, and paresthesia of the lower lip for the past 1 month. Past medical and surgical histories were non-contributory. The patient was conscious, alert, and oriented. No signs of pallor, icterus, cyanosis, clubbing, edema, and lymphadenopathy were present. The pulse rate was 72/min, respiratory rate was 16/ min, blood pressure was 120/80 mmHg, and the temperature was 98.6°F. On extraoral examination, an ill-defined, diffuse swelling, approximately 5×2 cm on the left side of the mandible extending from the angle to the parasymphysis medially was evident (Fig. 1a). On palpation, the swelling was non-warmth, non-tender, and hard in consistency. On neurosensory examination, twopoint discrimination, and light touching tests showed decreased sensation on the lower lip and the labial mucosa. Intraorally, an ill-defined, hard, non-tender, and non-pulsatile tumefaction with bicortical expansion obliterating the left mandibular buccal vestibule in relation to 33-38 was evident (Fig. 1b). Electric pulp vitality testing showed a negative response in those teeth. Teeth 35, 36, and 37 were inclined lingually with grade-I mobility. Intraoral periapical radiograph (IOPA), lateral mandibular occlusal, and the panoramic radiograph showed a

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Section: Discussionmentioning

confidence: 67%

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Ramesh¹,

Jayachandran²

2020

IJCR

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“…Il faut savoir que le risque de dégénérescence et de récidive du schwannome est très rare voire exceptionnel, cela s'explique par l'encapsulation du schwannome [10][11][12][13]. À l'inverse, le neurofibrome n'est pas une tumeur encapsulée et un taux de récidive d'environ 23,5 % est observé pour les neurofibromes solitaires.…”

Section: Discussionunclassified

Neurofibromatose, frontière entre schwannome et neurofibrome. À propos d’un cas clinique et revue de littérature

Bernardo

Butel

Langlois

et al. 2015

Med Buccale Chir Buccale

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Résumé -Introduction :Aujourd'hui, les pathologistes s'accordent à dire que schwannome, neurinome, neurilemmome et fibroblastome périneural sont des synonymes, ils font partie des neurofibromatoses de type II. Observation : Il s'agissait d'une patiente initialement adressée pour un schwannome bénin intramandibulaire. Cette lésion présentait des ressemblances sur le plan clinique et radiologique avec le schwannome, mais cette piste diagnostique n'était pas confirmée par le médecin anatomo-pathologiste. Discussion : Les anatomo-pathologistes distinguent cette tumeur du neurofibrome, retrouvé dans la neurofibromatose de type I. En effet, les neurofibromes prennent naissance à partir d'éléments conjonctifs (cellules de Schwann, fibroblastes et autres cellules du périnèvre) alors que les schwannomes sont une prolifération à partir de cellules de Schwann uniquement. Le diagnostic en est d'autant plus difficile et dépend de la pièce opératoire à analyser ainsi que de la compétence de l'anatomo-pathologiste. Conclusion : Cette observation clinique illustre la difficulté de la démarche diagnostique quand le clinicien fait face à des tumeurs peu fréquentes. Elle conforte la place de l'examen anatomo-pathologique dans la quête du diagnostic positif.Abstract -Neurofibromatosis, frontier between schwannoma and neurofibroma. A case report and literature review. Introduction: Today, pathologists agree that schwannoma, neurinoma, neurilemmoma and perineural fibroblastoma are synonymous; they are part of neurofibromatosis type II. Observation: A female patient presented mandibulary lesions initially diagnosed as a schwannoma. Indeed, the clinical and radiological aspects of these lesions showed similarities to schwannoma. However, this initial clinical diagnosis was not confirmed by the pathologist. Discussion: Pathologists differentiate schwannoma from neurofibroma, found in neurofibromatosis type I. Indeed, neurofibroma is formed by conjunctive elements (Schwann cells, fibroblasts and other cells of the perineurium), whereas schwannoma is exclusively a proliferation of Schwann cells. So, the diagnosis will be harder, and depends on the surgical specimen to be analysed and the ability of the pathologist. Conclusion: This clinical case illustrates the challenge of delivering a pertinent diagnosis and, finally, it highlights the importance of the histological examination for a positive diagnosis.

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“…Diversos autores reportan una prevalencia del 25 al 45% de estos tumores en cabeza y cuello, con predilección por la lengua, seguida de paladar, mucosa yugal, labios y encías [3,4]. La mayoría de los autores coinciden en que una manifestación intraósea mandibular es rara al representar el 1% de los tumores óseos primarios benignos, de los cuales la rama y el cuerpo mandibular son la ubicación más común a través del canal nervioso [3,[5][6][7][8][9].…”

Section: Introductionunclassified

Mega canal dentario en mandíbula Reporte de caso y revisión de literatura

Rodríguez-Lezama

2017

Rev. nac. odontol.

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Objetivo: presentación de un reporte de caso sobre una variación morfológica del canal dentario mandibular. Método: Se muestra evidencia radiográfica en una mujer adulta procedente del área urbana de Manizales –Colombia, que presenta aumento de tamaño del canal dentario sin evidencia clínica de deformidad mandibular ni sintomatología, el cual podría asociarse a tumoración benigna, debido al comportamiento que tiene desde que se encontró como hallazgo radiográfico en el 2013. Resultados: Los estudios biométricos del canal dentario determinan un diámetro promedio de 2.5 mm en condiciones de normalidad, lo que hace considerar esta expansión como una alteración del nervio alveolar inferior. Conclusiones: Se reporta una alteración expansiva ósea de un mega conducto dentario mandibular.

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Intraosseous Schwannoma of the Mandible

Cited by 4 publications

References 10 publications

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Neurofibromatose, frontière entre schwannome et neurofibrome. À propos d’un cas clinique et revue de littérature

Mega canal dentario en mandíbula Reporte de caso y revisión de literatura

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