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. 2020 Sep;14(3):571-576.
doi: 10.1007/s12105-019-01071-9. Epub 2019 Sep 4.

Tongue Schwannoma: A Clinicopathologic Study of 19 Cases

Lester D R Thompson  1 , Stephen S Koh  2 , Sean K Lau  2
Affiliations

Tongue Schwannoma: A Clinicopathologic Study of 19 Cases

Lester D R Thompson et al. Head Neck Pathol. 2020 Sep.

Abstract

Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely affect the tongue. The clinical and pathologic features of 19 cases of schwannoma arising in the tongue were analyzed. There were 13 males and 6 females ranging in age from 12 to 82 years (mean 34 years; median 29 years). The majority of tumors presented as an asymptomatic mass localized to the anterior two-thirds of the tongue. Histologically, 18 schwannomas exhibited characteristic Antoni A and B areas with the former pattern predominating. One tumor was composed exclusively of cellular Antoni A tissue and was classified as a cellular schwannoma. Tumor encapsulation was variable with nearly half of the lesions lacking a well-defined fibrous capsule. All were strongly and diffusely positive for S-100 protein. No recurrences were observed on clinical follow-up. Schwannoma of the tongue, although rare, should be separated from other types of lingual nerve sheath proliferations and tumors.

Keywords: Lingual; Neurilemmoma; Oral cavity; Peripheral nerve sheath neoplasm; S100 protein; Schwannoma; Tongue; Tongue neoplasms.

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Conflict of interest statement

All authors declare that they have no conflict of interest as it relates to this research project.

Figures

Fig. 1
Fig. 1
A partially ulcerated mass identified on the anterior tongue of a male patient (courtesy Dr. B. L. Nelson)
Fig. 2
Fig. 2
a Schwannoma of the tongue presenting as a circumscribed submucosal nodule. b This example of lingual schwannoma is surrounded by a fibrous capsule (black arrow). c A subset of schwannomas of the tongue had well demarcated borders but lacked a well-defined capsule. d Unencapsulated schwannoma with surface ulceration (black arrow)
Fig. 3
Fig. 3
a Typical biphasic histologic appearance of schwannoma of the tongue with compact cellular Antoni A area (left) adjacent to less cellular Antoni B area (right). b Antoni A tissue characterized by spindle cells arranged in short fascicles with areas of subtle nuclear palisading. c Antoni B tissue composed of loosely arranged ovoid to spindled cells in a myxoid stroma. d. Well-formed Verocay bodies
Fig. 4
Fig. 4
a Cellular schwannoma consisting of intersecting fascicles of spindle cells. b Areas of prominent vascularity with ectatic and hyalinized blood vessels (black arrow) were infrequently observed in tongue schwannomas
See this image and copyright information in PMC

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