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Ancient neurilemmoma: A rare oral tumor.

Muruganandhan J, Prasad TS, Selvakumar T, Kumar SN - J Oral Maxillofac Pathol (2013)

Bottom Line: Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns.They are extremely rare in the oral cavity and present in older individuals of long duration.This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Sri Venkateswara Dental College and Hospital, Thalambur, Chennai, Tamil Nadu, India.

ABSTRACT
Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns. Ancient neurilemmomas are usually longstanding growths that exhibit degenerative features that could be mistaken for malignancy. They are extremely rare in the oral cavity and present in older individuals of long duration. The authors report a case of ancient neurilemmoma in a young patient with short duration of growth. This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change. It is essential to not mistake these features as malignant transformation so as to avoid radical procedures.

No MeSH data available.


Related in: MedlinePlus

Photomicrographs of the cellular atypia. (H&E stain, ×400)
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Figure 7: Photomicrographs of the cellular atypia. (H&E stain, ×400)

Mentions: The cut-section of the excised tissue revealed a solid lesion with hemorrhagic areas [Figure 1b]. On histopathological examination, the lesion presented as a circumscribed cellular mass [Figure 2]. The cells were mostly spindle shaped with oval/blunt elongated nuclei. They were arranged in two patterns. One pattern was a palisaded arrangement of cells encircling eosinophilic structures (suggestive of Verocay bodies) [Figure 3]; and the other pattern was an irregularly arranged configuration of spindle cells, sometimes in a loose myxoid background [Figure 4a and b]. These patterns appeared consistent with descriptions of Antoni A and Antoni B patterns observed in schwannomas. There was significant vascularity throughout the lesion, with thick-walled blood vessels surrounded by hyalinization and inflammatory cells [Figure 5a and b]. Extravasated red blood cells (RBCs), hemosiderin deposition and siderophages were occasionally encountered [Figure 6]. In some areas, the spindle cells revealed nuclear pleomorphism and increased nuclear cytoplasmic ratio [Figure 7a and b]. Mitotic activity was insignificant, with mitotic index (MI) <1 per high power field (HPF). No abnormal or bizarre mitotic figures were observed.


Ancient neurilemmoma: A rare oral tumor.

Muruganandhan J, Prasad TS, Selvakumar T, Kumar SN - J Oral Maxillofac Pathol (2013)

Photomicrographs of the cellular atypia. (H&E stain, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927354&req=5

Figure 7: Photomicrographs of the cellular atypia. (H&E stain, ×400)
Mentions: The cut-section of the excised tissue revealed a solid lesion with hemorrhagic areas [Figure 1b]. On histopathological examination, the lesion presented as a circumscribed cellular mass [Figure 2]. The cells were mostly spindle shaped with oval/blunt elongated nuclei. They were arranged in two patterns. One pattern was a palisaded arrangement of cells encircling eosinophilic structures (suggestive of Verocay bodies) [Figure 3]; and the other pattern was an irregularly arranged configuration of spindle cells, sometimes in a loose myxoid background [Figure 4a and b]. These patterns appeared consistent with descriptions of Antoni A and Antoni B patterns observed in schwannomas. There was significant vascularity throughout the lesion, with thick-walled blood vessels surrounded by hyalinization and inflammatory cells [Figure 5a and b]. Extravasated red blood cells (RBCs), hemosiderin deposition and siderophages were occasionally encountered [Figure 6]. In some areas, the spindle cells revealed nuclear pleomorphism and increased nuclear cytoplasmic ratio [Figure 7a and b]. Mitotic activity was insignificant, with mitotic index (MI) <1 per high power field (HPF). No abnormal or bizarre mitotic figures were observed.

Bottom Line: Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns.They are extremely rare in the oral cavity and present in older individuals of long duration.This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Sri Venkateswara Dental College and Hospital, Thalambur, Chennai, Tamil Nadu, India.

ABSTRACT
Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns. Ancient neurilemmomas are usually longstanding growths that exhibit degenerative features that could be mistaken for malignancy. They are extremely rare in the oral cavity and present in older individuals of long duration. The authors report a case of ancient neurilemmoma in a young patient with short duration of growth. This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change. It is essential to not mistake these features as malignant transformation so as to avoid radical procedures.

No MeSH data available.


Related in: MedlinePlus