Gnathic Schwannomas: A Report of Two Cases and Systematic Review of the Literature

Peraza Labrador A.J.; Valdez L.H.M.; Marin N.R.G.; Ibazetta K.A.R.; Villacis M.; Chacon J.L.; Huaman H.O.; Pariahuamán H.C.; Angulo H.B.; Woo V. · Head and Neck Pathology (2023) · DOI: 10.1007/s12105-023-01595-1

Resumen

Background: The intraosseous schwannoma (IS) is a benign peripheral nerve sheath tumor postulated to arise de novo or from nerve fibers in preexisting nutrient canals. ISs are uncommon and comprise less than 1% of neoplasms originating in bone. We herein present two cases of mandibular schwannomas—the first case was a 66-year-old female with a four-month history of pain and pressure associated with an anterior mandibular radiolucency, and the second case was an asymptomatic 12-year-old female with separate radiolucencies of her mandibular symphysis and right posterior mandible. Incisional biopsies of all three lesions showed a benign spindle cell neoplasm with histologic features of a schwannoma; the tumor cells were strongly reactive for S-100. The patients underwent complete enucleation of their lesions and are without evidence of disease at ten months and five years, respectively. Methods: A systematic review was undertaken to evaluate the diagnostic features, treatment, and patient outcomes of gnathic schwannomas. Results: A total of 93 cases were identified with the following demographic findings: predominance in females (57%); average age of occurrence of 37.3 years (8 to 77 years); mean size of 3.6 cm; and involvement of the mandibular body (37.6%), mandibular body and ramus (18.3%), and anterior mandible (18.3%). The predominant clinical sign was swelling (69.9%), and the most common radiographic presentation was a radiolucency (94.6%) with well-defined borders (72%). Conclusion: All cases were treated surgically, with an average follow-up interval of 22.9 months and a recurrence rate of 5.4%