Sublingual Schwannom

Öz

Schwannomalar, periferik, kranial ve otonomik sinir kılıflarındaki schwann hücrelerinden kaynaklanan benign tümörlerdir. Schwann hücresi içeren sinir liflerinin bulunduğu her yerde görülebilmekle beraber, %25-45 kadarı baş-boyun bölgesinde görülür. İntraoral yerleşimleri daha nadirdir. Ancak, preoperatif tanı koymadaki zorluk nedeniyle, bu bölge kitlelerinde ayırıcı tanıda akılda tutulmalıdır. Biz, 14 yaşında sublingual bölgede 6 aydır büyüme gösteren ve dil hareketlerinde kısıtlılığa sebep olan ağrısız kitle şikâyeti başvuran hastada görüntüleme yöntemleri ve ince iğne aspirasyon biyopsi sonucu tanı koymada yetersiz olması nedeniyle insizyonel biyopsi ile schwannoma tanısı konulan bir olgu sunuyoruz. Kitle intraoral yaklaşımla total eksize edilmiş ve bir yıllık takibinde nükse rastlanmamıştır.

Anahtar Kelimeler

• Schwannoma, Sublingual, Çocuk

SUBLINGUAL SCHWANNOMA

Öz

Schwannomas are benign tumors that originate from the schwann cells surrounding periferic, cranial and autonomic nerves. Although it can occur at any location where there are nerve fibers with schwann cells, about %25 to 45 of schwannomas occur in the head and neck region. Intraoral localization is more rare. However, because of the potential difficulties associated with preoperative diagnosis, schwannoma should be considered for differential diagnosis of head and neck masses. In the present case, we presented a 14 year old patient who had a painless mass at his sublingual region that was progressively growing for 6 months and blocking tongue movements. The patient was diagnosed as schwannoma upon incisional biopsy because imaging methods and fine neddle aspiration biopsies were inadequate. The mass was totally excised by intraoral approach and there was no relapse in his 1 year follow up

Anahtar Kelimeler

• Neurilemmoma, Sublingual, Child

Kaynakça

1. Hornick P, John LC, Murray A, Davis S, Croft RJ, Lumley JS. Neurilemmoma as a cause of combined thoracic outlet and Horn- er’s syndrome. Thorac Cardiovasc Surg 1991;39(4):232-3.
2. Stout AP. Tumors of the peripheral nervous system. Mo Med 1949;46(4):255-9.
3. Yıldırım M, Yorgancılar E, Bulut F, Meriç F, Topçu İ. Nazal tip Schwannomu: Vaka sunumu ve literatürlerin kısaca gözden geçirilmesi. Turk Arch Otolaryngol 2009; doi:10.2399/tao.08.031.
4. Gallo WJ, Moss M, Shapiro DN, Gaul DN. Neurilemmoma: review of the literature and report of five cases. J Oral Surg 1977;35(3):235-6.
5. al-Ghamdi S, Black MJ, Lafond G. Extracranial head and neck schwannomas. J Otolarygol 1992;21(3):186-8.
6. Sharaki MM, Talaat M, Hamam SM. Schwannoma of the neck. Clin Otolaryngol Allied Sci 1982;7(4):245-51.
7. Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign soli- tary schwannomas (neurilemomas). Cancer 1969;24(2):355-66.
8. Haberal A, Turgut F, Turgut M, Koç S, Köse F, Özfuttu A, et al. A Case of Malignant Schwannoma Of the Pelvic Sympathetic Plexus in A Girl with Neurofibromatosis Type 1. Turkiye Klinikleri J Gy- necal Obst 1994;4;(3):203-5.

9. Attie JN, Friedman E, Rothberg MS. Submandibular and axillary schwannomas not associated with von Recklinghausen’s disease. J Oral Maxillofac Surg 1984;42(6):391-4.
10. Sutay S, Tekinsoy B, Ceryan K, Aksu Y. Submaxillary hypoglossal neurilemmoma. J Larygol Otol 1993;107(10):953-4.
11. Sato J, Hilmi T, Matsui T. Parasympathetic schwannoma of the submandibuler gland. Auris Nasus Larynx 2001;28(3):283-5.
12. Arda HN, Akdoğan O, Arda N, Sarıkaya Y. An unusual site for an intraoral schwannoma: A case report. Am J Otolaryngol 2003;24(5):348-50.
13. Martins MD, Jesus LA, Fernandes KP, Bussadori SK, Taghloubi SA, Martins MA. Intra-oral schwannoma: Case report and litera- ture review. Indian Journal of Dent Res. 2009;20(1):121-5.
14. Biswas D, Marnane CN, Mal R, Baldwin D. Extracranial head and neck schwannomas- a 10 year review. Auris Nasus Larynx 2007;34(3):353-9.
15. Yu GH, Sack MJ, Balock Z, Gupta PK. Diffuculties in the fine needle aspiration (FNA) diagnosis of schwannoma. Cytopathology 1999;10(3):186-94.
16. Yamazaki H, Kaneko A, Ota Y, Tsukinoki K. Schwannoma of mental nevre: Usefulness of the preoperative imaging: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):122-6.
17. Artzi Z, Taicher S, Nass D. Neurilemoma of mental nevre. J Oral Maxillofac Surg 1991;49(2):196-200.
18. Iwamoto Y, Mizukawa N, Sekimoto T, Nakahara Y. A case of cer- vical vagus neurinoma with hypoglossal palsy. No To Shinkei. 1993;45(6):567-70.