Mandible schwannoma (neurilemmoma) presenting as periapical lesion

Abstract

Schwannoma is a benign nerve tumour that originates from Schwann cells, which cover peripheral nerves. Intraosseous schwannoma of the jaw is rare. Primary schwannoma of the mandible presenting as a periapical radiolucency on a non-vital endodontically treated tooth has rarely been referred to in the English medical literature. A rare case of intraosseous schwannoma is reported in a 23-year-old woman. The patient presented clinically with a painful swelling on the right side of the mandible and with a radiologically ill-defined unilocular periapical lesion around the mesial root of the endodontically treated first molar. Surgical treatment involved complete excision of the lesion with a mesial and distal root resection. Histological and immunohistochemical examination showed that the lesion was a primary intraosseous schwannoma of the mandible. Immunohistochemical examination showed a positive and strong reaction for S-100 protein, characteristic of neural tumours. 1 year following surgery, there were no regional recurrences. Radiographically, mandibular intraosseous schwannoma is difficult to differentiate from bone tumours such as ameloblastoma, myxoma, fibrous dysplasia, neurofibroma, central giant cell lesion or periapical lesion, so it should be included in the list of possible periapical pathoses.

Clinical, Pathological, And Immunohistochemical Analysis Of Schwannoma In Oral Cavity: A Case Report

“…24 It is reported that when vimentin is negative, angioleiomyomas can be discarded. 12,25 As to Leu-7, it showed a positive expression ( Figure 2D). This protein is an antigenic marker of lymphocytes, specific for natural killer cells, which is expressed in benign and malignant nerve sheath tumors, as well as in neuroendocrine tumors.…”

“…11,12 Además, la proteína ki-67, como marcador, permite determinar la proliferación celular. 13 Generalmente, el pronóstico de esta lesión es bueno; su transformación maligna se ha reportado en pocas ocasiones.…”

“…24 Se ha reportado que cuando la vimentina es negativa, se pueden excluir los angioleiomiomas. 12,25 Para Leu-7 se presentó una expresión positiva (Figura 2D). Esta proteína es un marcador antigénico de los linfocitos, específico para células asesinas naturales, que se expresa dentro de los tumores de vaina nerviosa benignos y malignos, así como en tumores neuroendocrinos.…”

“…3 Otros marcadores celulares asociados a tumores neuronales son: E.N.E., vimentina, glycoprotein, SMA, desmin, and dimentin (leu-7). 11,12 In addition, the ki-67 protein as a marker allows determining cell proliferation.…”

Schwannome intra-osseux mandibulaire : un cas chez un enfant de 7 ans

“…Une hyperplasie gingivale est fréquemment présente [19]. Les femmes sont plus atteintes que les hommes [20,21]. La plupart des neurofibromes sont asymptomatiques.…”