Oral peripheral nerve sheath tumors: A clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

Abstract

BackgroundOral peripheral nerve sheath tumors (OPNSTs) are reactive or neoplastic diseases that develop from proliferation of the nerve itself or their limiting sheaths. Here we describe the clinicopathologic data of OPNSTs observed in a sample of the Brazilian population and evaluate the expression of molecules associated with neural biology to determine their usefulness in the diagnosis.Material and MethodsDescriptive study of cases diagnosed as OPNSTs, from the Pathology Laboratory at the School of Dentistry/ Federal University of Uberlandia, followed by an immunohistochemical study of S-100, CD57, neurofilament protein (NFP) and epithelial membrane antigen (EMA).ResultsOPNSTs comprised 0.27% of all biopsies. There were eight patients with neurofibromas, eight with traumatic neuromas, seven with schwannomas, five with granular cell tumor (GCT), and four with palisaded encapsulated neuromas (PEN). Women were more frequently affected (60.6% of the cases). Tongue and lips prevailed as the most frequent sites. S-100 was reactive in 100% of the cases. Neural fibers evidenced by CD57 reactivity of their Schwann cells were always nested in bundles within neurofibromas and GCT, absent within schwannomas and dispersed within PEN. Reactivity for NFP was limited to axons and then followed the same pattern of CD57, though much less evident. Reactivity for EMA was observed in the capsular tissues and perineurium of nerve fascicles, and absent in parenchymal cells of GCT.ConclusionsThis study showed that OPNSTs are rare, widely benign and often found in tongue and lips. OPNSTs evolve from a common origin to distinct histological patterns, with eventual overlapping in their clinical and morphologic features. The arrangement of reactive residual neural fibers for CD57 can be a useful staining in the differential diagnosis of OPNSTs. Key words:Peripheral nerve sheath tumors. Oral cavity. Differential diagnosis. Immunohistochemistry. CD57 antigens.

Oral granular cell tumour: A multicentric study of 56 cases and a systematic review

“…This fact emphasises the neoplastic nature of this pathology and the need for its complete surgical excision. None of the patients from our series presented more than one GCT lesion, in contrast with the findings from other studies included in our review (Apisarnthanarax, ; Baden et al, ; Bamps et al, ; Bangle, ; Bomfin et al, 2009; Chrysomali et al, ; Collins & Jones, ; Franco et al, ; Manara et al, ; Sargenti‐Neto et al, ; van de Loo et al, ), in which 8% of the patients presented multiple lesions, including oral and extraoral. Some multifocal extraoral cases have already been associated with neurofibromatosis type 1 (NF1) or Noonan syndrome (Martin, Neldner, Boyd, & Coates, ; Ramaswamy, Storm, Filiano, & Dinulos, ; Sahn, Dunlavey, & Parsons, ).…”

“…Most of the cases corresponded to asymptomatic slow‐growing tumours (63%). Only seven patients (2.6%) presented multiple oral GCT lesions (Apisarnthanarax, ; Baden et al, ; Bamps et al, ; Chrysomali et al, ; Collins & Jones, ; Franco et al, ; and Manara et al, ), and 5 (1.8%) presented both oral and extraoral tumours (Bomfin, Abreu, Almeida, Kowalski, & Cruz Perez, 2009; Bangle, ; Bamps et al, 2013; Sargenti‐Neto et al, ; van de Loo et al, and Vera‐Sempere, Vera‐Sirera, Zabala, Aviño‐Mira, & Vera‐Sempere, ), one of them with Noonan syndrome (Bamps et al, 2013).…”

“…Currently, immunohistochemical positivity for S100 protein is considered as a diagnosis requirement for GCT (Vered et al, ). Likewise, GCT presents a particular immunohistochemical profile, expressing CD57 (nerve fibres), CD56 (dendritic/macrophages cells), PGP9.5 (neurons), p75 (nerve growth factor) and NSE (neuron‐specific enolase), and is negative for EMA (epidermal membrane antigen), synaptophysin (synaptic vesicle) and neurofilament protein (Franco et al, ).…”

Oral neural tumors: Clinicopathologic analysis of 157 cases and review of the literature

“…TN is the first (5,8,9), second (6,7) or third (current study) most frequent ONT. It is a reactive lesion (1) and represents a copious growth response to nerve injury (47).…”

“…NF is less prevalent than schwannoma in the head and neck area, whereas the opposite applies when they occur intraorally (21). It is the first (6,7,9,10) or second (5,8, current study) most common ONT. In the majority of cases, it arises in soft tissues, while it is very rare to appear in the jaws (22).…”