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

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Abstract

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%

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Data Availability

Data analyses was performed with Microsoft Excel 2023 (Microsoft Corp, Redmond, Washington) and the Statistical Package for the Social Sciences (SPSS) software, version 20.0 Copyright IBM (SPSS Inc., Chicago, IL, USA). All information presented in the manuscript is available.

Code Availability

Statistical Package for the Social Sciences (SPSS) software, version 20.0 ©Copyright IBM (SPSS Inc., Chicago, IL, USA).

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Acknowledgements

We are indebted to Dr. Steven Saxe and Dr. Jeff Moxley (oral surgery) for providing their clinical and surgical expertise to case 2. A special thank you to Dr. Mark Lingen (oral and maxillofacial pathology), Dr. Jill Ono (anatomic pathology), and Dr. Ronald Knoblock (anatomic pathology) for sharing their expert opinions on case 2.

Funding

None.

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Authors and Affiliations

  1. College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA

    Alberto Jose Peraza Labrador & Victoria Woo

  2. Diagnocentrobucal, Las Golondrinas Mz. B lote 9. Los Olivos, Lima, Peru

    Luciano Hermios Matos Valdez

  3. Department of Otolaryngologist, Military Hospital Bogota, Bogota, Colombia

    Nestor Ricardo Gonzalez Marin

  4. Oral and Maxilofacial Pathology and Medicine Clinics, Av. Pablo Carriquiry 705 San Isidro, Lima, Peru

    Karem Annelise Rodriguez Ibazetta, Joan Lopez Chacon & Hebert Ochoa Huaman

  5. International University of Ecuador, Quito, Ecuador

    Marcelo Villacis

  6. Department of Diagnostic Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave, Dallas, TX, 15082, USA

    Harold Cuzcano Pariahuamán & Hosting Barría Angulo

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  1. Alberto Jose Peraza Labrador
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APL: Action performed: Search and paper selection, Prospero writing, data analyze, Oxford codification, discussion writing. LMV: Action performed: paper selection, paper analyzes, writing. NGM: Action performed: Data analyzes, statistic software analyzes. KRI: Action performed: Oxford codification, Prospero writing. MV: Action performed: excel data, table 1, table 2 and oxford codification. JL: Action performed: writing document, table 2, data analyze. HOH: Action performed: search papers, Search, table 2. HC: Action performed: excel data, oxford codification, figure 1. HB: Action performed: figure 1, discussion writing. VW: Action performed: writing results, table 2, case report information, data analyzes.

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Correspondence to Alberto Jose Peraza Labrador.

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Peraza Labrador, A.J., Valdez, L.H.M., Marin, N.R.G. et al. Gnathic Schwannomas: A Report of Two Cases and Systematic Review of the Literature. Head and Neck Pathol 17, 984–999 (2023). https://doi.org/10.1007/s12105-023-01595-1

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