Epithelioid schwannoma in the buccal region: A case report and review of literature

Abstract

Schwannomas are common, benign peripheral nerve sheath tumors that arise from Schwann cells. Several rare morphological variants include ancient, cellular, plexiform, epithelioid, and microcystic/reticular. The epithelioid variant of schwannoma is scarce, with only a few relevant cases reported in the oral and maxillofacial regions. Herein, we report a case of epithelioid schwannoma in the buccal region. A 61-year-old woman was referred to our department from a medical clinic because of a slow-growing nodule in the buccal region, noticed 3 years before presentation. Clinical examination revealed a nodular mass measuring 20 × 20 mm. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an oval lesion with a clear border on the left cheek. The outer margin of the mass exhibited opacities that appeared as multiple microcalcifications. MRI revealed a well-defined mass similar in size to that observed on CT, with low signal intensity on T1-weighted images and mildly high signal intensity on T2-weighted images. The clinical differential diagnosis includes benign tumors such as pleomorphic adenoma. The tumor was surgically excised under general anesthesia. Histopathological examination revealed multilobulated epithelioid cells arranged in nests. The tumor cells showed eosinophilic cytoplasm and uniformly round nuclei. The tumor was diagnosed as an epithelioid schwannoma. Postoperative follow-up was uneventful, and no evidence of recurrence was observed 2 years postoperatively.