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      Ancient Schwannoma of the hard palate. An uncommon case report and review

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          Abstract

          Schwannoma or neurilemmoma is an infrequent benign tumor in the oral cavity that originates from the Schwann cells on the neural sheath of the peripheral nerves. Schwannomas are frequently located in the soft tissues of head and neck region, but only a 1 to 12% of them are located in the oral cavity. Some histological variants of schwannoma have been described including the cellular, plexiform, epithelioid, ancient, and melanocytic types. The “ancient schwannoma” is an uncommon variant of this tumor that shows specific histological characteristics, and is rare in the oral cavity with less than 15 cases described on the literature. Most of them were located in the tongue or in the floor of the mouth, being the hard palate an extremely rare localization. We present a new clinical case of an ancient schwannoma with a long time of evolution, arising from the nasopalatine nerve, and located in the hard palate of a 35 year old female. We also review the main clinical and histological characteristics of this pathology.

          Key words:Ancient schwannoma, neurilemmoma, palate, schwannoma.

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          Most cited references17

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          Head and neck schwannomas--a 10 year review.

          Schwannomas of the head and neck are uncommon tumours that arise from any peripheral, cranial or autonomic nerve. Twenty-five to 45 per cent of extracranial schwannomas occur in the head and neck region and thus are usually in the domain of the otolaryngologist. They usually present insidiously and thus are often diagnosed incorrectly or after lengthy delays, however, better imaging and cytological techniques have lessened this to some degree more recently. For benign lesions conservative surgical excision is the treatment of choice bearing in mind possible vagal or sympathetic chain injury. Malignant schwannomas are best treated with wide excision where possible. The role of adjuvant therapy remains uncertain and irrespective of treatment modality prognosis is poor with an overall survival of 15 per cent. However, recent advances in ras oncogene inhibitors may hold hope for the future.
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            Schwannoma of the tongue: report of 2 cases.

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              Schwannoma of the tongue: two case reports and review of the literature

              The aim of this study was to describe clinicopathologic and radiographic features of two cases of schwannoma involving the oral tongue and to review the literature of this unusual clinical entity. Case reports with review of the pathologic, radiologic and clinical data for two patients with schwannoma of the tongue are reported. Review of the literature of case reports of schwannomas (neurilemmomas) of the tongue from 1955 to 2006 with analysis of the patient’s age, gender, presenting symptom(s), tumor size, and surgical approach was undertaken. The two patients in our series presented with painless swelling of the tongue. Transoral excision was performed and pathologic examination confirmed the diagnosis of schwannoma in both the cases. A total of 126 cases of schwannoma of the tongue have been reported in the English literature over the past 51 years. Schwannomas of the tongue typically present in the third decade of life (33%), display no gender predilection (52.8% female; 47.2% male) and often present as a painless mass (69.6%). Schwannomas are likely to elicit distressing symptoms when they occur in the posterior one-third of the tongue (63.2 vs. 13.5%) or approach 3 cm in greatest dimension (33.0 vs. 18.2 mm). The vast majority of cases have been treated with transoral excision (94.8%). Recurrence after surgical excision has not been reported. Schwannoma of the tongue is a relatively rare tumor of the head and neck. Transoral resection allows for removal of this tumor in a manner that precludes recurrence, avoids causing morbidity of tongue function, and remains the standard approach for the treatment of the vast majority of these tumors.
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                Author and article information

                Journal
                J Clin Exp Dent
                J Clin Exp Dent
                Medicina Oral S.L.
                Journal of Clinical and Experimental Dentistry
                Medicina Oral S.L.
                1989-5488
                1 February 2013
                February 2013
                : 5
                : 1
                : e62-e65
                Affiliations
                [1 ]Oral Medicine Unit. Oral and Maxillofacial Pathology Unit. Faculty of Medicine and Dentistry. UFI 11/25.University of the Basque Country / EHU
                Author notes
                Units of Oral Medicine and Oral & Maxillofacial Pathology Dental Clinic Service. Faculty of Medicine and Dentistry University of the Basque Country/EHU. Leioa. Spain Barrio Sarriena s/n. 48940. Leioa, Spain , E-mail: aeguiadelvalle@ 123456yahoo.es

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                Article
                50950
                10.4317/jced.50950
                3892226
                24455054
                2cc45c16-90cd-4a54-9d23-93bc858e9846
                Copyright: © 2013 Medicina Oral S.L.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 October 2012
                : 3 August 2012
                Categories
                Case Report
                Oral Medicine and Pathology

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