Schwannoma of the upper lip

Abstract

AbstrAct:Schwannoma is a benign tumor of neural origin. This condition is uncommon in the upper lip. The aim the present study was to perform an analysis of lip lesions at an oral pathology laboratory to determine the frequency of schwannoma of the upper lip and perform a literature review to correlate with the cases of this study. A retrospective analysis was performed at the oral pathology laboratory and the histopathological records from 1946 to 2012 were retrieved and organized in a database. Cases of schwannoma of the upper lip were identified and analyzed. Moreover, a literature review was performed on schwannomas found in this same anatomic site. In this period, 1195 lip lesions were diagnosed, among which four were cases of schwannoma on the upper lip (0,33%). Of these, 3 cases were in women; the mean age of patients was 45 years old. In all cases the clinical diagnosis hypothesis involved reactive lesion or benign neoplasm. The final diagnosis of schwannoma was obtained following the histopathological examination of the surgical specimens. This study emphasizes the low frequency of schwannoma in the upper lip and the importance of histological evaluation to define the final diagnosis which usually represents unexpected outcomes.

Plexiform schwannoma in the maxillary alveolar ridge

“…Incisional biopsy and anatomopathological analysis are the key to the diagnosis of schwannoma. According to the literature, this tumor has sizes ranging from 8mm to 5 cm 15 , similar to the piece obtained after total excision of the lesion that had its largest diameter 1.02 cm, according to Curra et al 19 , 2016 who suggests performing an excisional biopsy from the diagnosis.…”

“…8 Plexiform schwannoma is a rare variant of the conventional schwannoma, first described by Harkin et al in 1978. 19 It is a benign tumor without metastatic potential composed exclusively of SC and is characterized macroscopically and microscopically as an intraneural, plexiform lesion, often with multinodular growth and with a pattern of multifocal tumor origin that extends over one or more fascicles nervous. 6,19 PS is a solitary tumor, sporadic and not associated with the development of type 1 neurofibromatosis, although when they affect one or more nerves, they strongly suggest an association with type 2 neurofibromatosis (associated with intracranial and spinal tumors) 6 and schwannomatosis (multiple cutaneous PS), in a relative proportion of approximately 5% chance.…”

“…19 It is a benign tumor without metastatic potential composed exclusively of SC and is characterized macroscopically and microscopically as an intraneural, plexiform lesion, often with multinodular growth and with a pattern of multifocal tumor origin that extends over one or more fascicles nervous. 6,19 PS is a solitary tumor, sporadic and not associated with the development of type 1 neurofibromatosis, although when they affect one or more nerves, they strongly suggest an association with type 2 neurofibromatosis (associated with intracranial and spinal tumors) 6 and schwannomatosis (multiple cutaneous PS), in a relative proportion of approximately 5% chance. 6,19 In addition, it must be differentiated from the malignant tumor of the peripheral nerve sheath, traumatic neuroma, palisade encapsulated neuroma, conventional schwannomas with intratumoral nodularity and mainly of plexiform neurofibroma given its clinical and histological characteristics similar to PS and the great chance for the development of neurofibromatosis and malignancy.…”

Surgical treatment of Schwannoma in lower lip

“…Bhalerao et al 9 cited also the involvement of the buccal floor, salivary glands and mental nerve region. The present study shows the involvement of the lower lip, which makes the schwannoma in this region a rare benign neoplasm, once the lip is made up of connective tissue, fat and skin, as well as blood vessels, nerves and salivary glands, soon, the lesions most commonly found in this region are fibroma, fibrous inflammatory hyperplasia, tumors of the salivary glands and mucocele 11 .…”

“…The differential diagnosis must be established with schwannoma in neurofibroma, lipoma, hemangioma, granuloma, leiomyoma and linfagioma 14 . When the tumor occurs in the lip, fibroma, fibrous inflammatory hyperplasia and mucocele are also part of the differential diagnosis 11 . In this study, were established, lipoma, fibroma and fibrous inflammatory hyperplasia, mucocele as diagnostic hypotheses.…”