Investig Magn Reson Imaging.  2019 Dec;23(4):385-389. 10.13104/imri.2019.23.4.385.

Schwannoma of the Tongue Base with Imaging Features and Differential Diagnosis: a Rare Case Report and Literature Review

• Kim TK
• Kim HY
• Yu IK
• Son HJ
• Chang DS
• Jang YD

• KMID: 2468057
• DOI: http://doi.org/10.13104/imri.2019.23.4.385

Abstract

Schwannoma or neurilemmoma is a benign peripheral nerve sheath tumor that arises from Schwann cells. Approximately 25-45% of all schwannomas occur in the head and neck regions, and the intraoral presentation of these is only 1%. We report a rare case of a patient presenting tongue base schwannoma with characteristic imaging features on computed tomography and magnetic resonance imaging.

Keyword

Schwannoma; Nerve sheath neoplasms; Tongue; Computed tomography; Magnetic resonance imaging

MeSH Terms

Diagnosis, Differential*
Head
Humans
Magnetic Resonance Imaging
Neck
Nerve Sheath Neoplasms
Neurilemmoma*
Peripheral Nerves
Schwann Cells
Tongue*

Figure

• 

  Fig. 1 Axial, coronal and sagittal contrast-enhanced computed tomography images reveal heterogeneously enhanced mass with internal multiple nodular rim enhancing foci, arising from the tongue base.

• 

  Fig. 2 The mass reveals generally iso signal intensities on T1WI (a) and heterogeneously high signal intensities with multiple internal ring-like lesions on T2WI (b). On sagittal T1WI (c), slightly high signal intensity at the peripheral portion of the mass (white arrow) is also noted. On the gadolinium-enhanced fat-suppressed T1WI (d), it shows bright and heterogeneous enhancement. T1WI = T1-weighted image; T2WI = T2-weighted image.

• 

  Fig. 3 Gross pathologic examination (a) reveals a well circumscribed brownish tan color mass. In the section, the mass was 42 × 40 × 30 mm sized in dimension. Hematoxylin and Eosin (H&E, × 100) staining shows that the tumor was composed of spindle cells and loose myxoid stroma (b). In immunostaining (S-100, × 200), the tumor cells revealed diffuse positivity (c).

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