Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5611
Peer-review started: July 21, 2020
First decision: August 8, 2020
Revised: August 19, 2020
Accepted: October 1, 2020
Article in press: October 1, 2020
Published online: November 26, 2020
Processing time: 127 Days and 3.5 Hours
Schwannoma is a rare benign, encapsulated tumor of the nerve sheath under the tongue, mostly occurring as solitary tumors with classical histological pattern and several common morphological variants. To our knowledge, multiple schwannomas with pseudoglandular element synchronously occurring under the tongue are rare; we report herein the first such case.
A 53-year-old man had first noticed an isolated asymptomatic mass under the tongue, and as the mass grew, the tongue was elevated. Physical examination showed multiple oval neoplasms, and the overlying mucosa was normal. Computed tomography showed three low-density oval neoplasms under the tongue, which were cystic-solid with unclear boundary. The patient has no cutaneous tumors, VIII nerve tumors, or lens opacities and no history of neurofibromatosis 2 or confirmed schwannomatosis in any first-degree relative. Magnetic resonance imaging showed no evidence of vestibular schwannoma. The preoperative diagnosis was mucoepidermoid carcinoma. During hospitalization, all neoplasms were completely excised by surgeons through an intraoral approach under general anesthesia. The diagnosis of the multiple schwannomas with pseudoglandular element was made by histopathology after surgery. At the 15-mo follow-up visit, the patient had no sign of recurrence or development of other peripheral nerve tumors.
Although rare, multiple schwannomas with pseudoglandular element do exist in patients presenting with masses under the tongue. Oral surgeons should be aware of the existence of multiple schwannomas with pseudoglandular element when considering masses under the tongue due to the different prognosis between multiple schwannomas with pseudoglandular element and mucoepidermoid carcinoma.
Core Tip: Schwannoma is a rare benign, encapsulated tumor of the nerve sheath under the tongue and mostly occurs as solitary tumors with classical histological pattern and several common morphological variants. Multiple schwannomas with pseudoglandular element synchronously occurring under the tongue are of great rarity. Here, we present the first report of a case of multiple schwannomas with pseudoglandular element synchronously occurring under the tongue.