Schwannoma of the tongue-A common tumour in a rare location: A case report

Abstract

Schwannoma is a benign tumour that arises from Schwann cells of the peripheral nerve sheath, and is a common tumour of the head and neck. However, intraoral location is very uncommon (only 1% of all head and neck schwannomas). We report a rare case of lingual schwannoma in a 20-year-old male patient who presented with a small, slow-growing mass over the right lateral border of the tongue with 1 year of evolution and that became recently ulcerated. The patient underwent MRI examination and complete surgical excision. Histopathological and immunohistochemical examination confirmed the diagnosis.

Keywords: MRI; Neurilemmoma; Oral cavity; Schwannoma; Tongue.

Fig. 1

MRI of the tongue revealed the presence of a well-circumscribed nodule on the right anterior tongue, homogeneously isointense to muscle on T1WI (A) and homogeneously hyperintense on T2WI (B), showing hypervascularity on contrast dynamic study, with homogeneous contract enhancement (D). A − T1 WI sagittal (TE: 13; TR: 590); B − T2 WI coronal (TE: 63; TR: 3340); T1 VIBE before (C) and after (D) gadolinium injection (TE: 12; TR: 624).

Fig. 2

Histological pictures coloured with H&E (A, B and C) and immunohistochemical staining for S-100 protein (D). A − At low power (H&E x 40) the capsule can be seen (arrow) as well as the Antony A (more cellular) and Antony B (paucicellular and more myxoid) components. B − At low power (H&E x 40) the ulcerated margin is evident, with haemorrhage and necrosis. C − At high power (H&E x 100) the palisading nuclei and Verocay bodies are evident, as well as the Antony A and Antony B components. The hypervascularity of the lesion can be noted, as many vessels are seen. D − Immunohistochemical staining revealed diffuse and strong positivity for S-100 protein.