In this report, we reported a case of malignant schwannoma in the submandibular region, reviewed 35 cases of malignant schwannoma in the head and neck region reported in the Japanese literature and discussed the pathological differential diagnosis.
The patient was a 73-year old woman referred by her dentist because of 4 her right submandibular lump. In the clinical examination including ultrasonic examination and xeroradiography, a benign tumor was strongly suspected. Based on the clinical diagnosis, surgical enucleation was carried out under local anesthesia. The tumor did not connect to the nerve or the submandibular gland. The specimen consisted of a nodular and smooth mass of grayishwhite tissue containing multiple cystic lesions and was examined by light microscope and electron microscope. The pathological diagnosis was malignant schwannoma. No adjuvant chemotherapy and radiotherapy were performed. At the present time the paitnet is comfortable without evidence of disease during 9 postoperative months.
Records of 34 patients found in Japanese literature and our new case wer reviewed. Of the 35 patients, one patient was excluded because of little information.
1. Sex: 15 men and 19 women.
2. Age: The age of the patients ranged from 13 to 73 years, with 65% of 34 patients between 20 to 49 years of age. Average age of 34 patients was 39.9 years, with no significant average age difference between men (40.9 years) and women (39. 1 years).
3. Anatomic distribution: 14 tumors were located in the neck and 9 in the maxilla. But there was no case primarily involving the mandible except one where the neck tumor invaded the mandible.
4. Initial sign and symptom: 25 of 34 patients were primarily seen because of the presence of a mass.
5. Treatment: 31 patients were treated primarily by resection and one patient was treated conservatively by irradiation because surgical intervention was impossible.
6. Prognosis: Of the 34 patients, 3 were without information about the prognosis. 16 of 31 patients developod local rccurrcnccs and 11 died at the time of the report.Because patients were counted as alivc regardless of the rccurrence at the time of the report in this review, it is probable that the longer the follow-up poriodis, the poorer the prognosisis.
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