SCHWANNOMA

A Schwannoma is a tumour of the tissue covering the nerve;

called the nerve sheath .These tumour develops from
schwann cell; which give their name schwannoma. This
tumor s is often benign in nature .The commonest type of
benign tumour is ACOUSTIC NEUROMA...Which can cause
deafness (because it grows on 8TH cranial nerve)?

INCIDENCE AND PREVALENCE

IT may arise at any age; cases have been reported even

during the 1st year of life as well as in elderly patient
There is no gender predilection
Lesions does occur with some frequency in patient with
neurofibromatosis
They can start at any part of the body. But the most
common site is in major nerve of leg (sciatic nerve) .In nerve
at top of the arm (brachial plexus), or in sacral plexus
They also occur around the nerve of head and neck.

ETIOLOGY

Sometimes can be related with radiation

Occurs in some instances in people suffering from

neurofibromatosis

CLINICAL FEATURES

It is a slowly growing lesion

Despite the fact that these tumor originate from nerve
tissue, they are usually painless, unless they are causing
pressure on the adjacent nerve rather than on the nerve of
origin.
Symptom of majority of patient is presence of tumor mass

ORAI MANIFESTATIONS
Head & neck are common regions for the development of
this neoplasm.
In mouth frequency of occurrence is palate, floor of mouth,
buccal mucosa, gin giva, lip, and vestibule
Sometimes Maxillary sinus and salivary glands as well as
the retropharyngeal, nasopharyngeal and retrotonsillar area
It is also been reported as central lesion within bone chiefly
the mandible, arising from the mandibular nerve.
Lesion occurring in the oral cavity is usually a single
circumscribed nodule of varying size that presents no
pathognomic features.
It may resemble any of benign oral tissue lesions.
Central lesion in bone may produce considerable destruction
of bone with expansion of cortical plates and thus resemble
a more serious lesion
Pain and Parasthesia may accompany these central lesions.

HISTOLOGIC FEATURES

Microscopic picture of schwannoma is a characteristic

feature and can seldom be confused with other lesions.
The tumor is classically described as being composed of two
types of tissues. Antoni type A and Antoni type B.

ANTONI TYPE A------

Tissue is made up of cells with elongated or spindle shaped

nuclei which are aligned to form a characteristic palliating
pattern, while the intercellular fibers are arranged in parallel
fashion between rows of nuclei.

These fibers in some planes give the impression of occurring

in whirls or swirls.

Antonitype B:
Tissues do not exhibit the characteristics palliating pattern
but rather or disorderly arrangements of cells and fibers with
areas of what appears to be oedema fluids and with
formation of microcysts.

Verocay bodies which are small hyaline structure are also

characteristically present in this tumour. In all the instances
these tumours are encapsulated.

MALIGNANT FORMS:

Malignant forms of schwannoma also occure which

commonly called malignant peripheral nerves sheats
tumours or MPNST OR NEURO FIBER SARCOMA.

They are rare tumours that come under the general heading
of soft tissue sarcoma.
Diagnostic Procedure

Diagnostic Procedure

CT scan
MRI

Treatment

It include Radiotherapy Surgery Chemotherapy

Radiotherapy is not very common because is not very
responsive to Xrays because it is an encapsulated tumor
AS well as radiotherapy may cause lot of normal tissue
damage.

On review of 54 patients with this type of nerve tumor

treated over the last ten years found the following people
likely to do best.

Had tumors smaller than 5cm.

Were able to have their tumor completely removed.

People who were of younger age.

These tumors are generally treated by surgical removal.

But if they reoccur then it means that it wasn’t removed

completely .there may just have been microscopic traces of
it left behind. This is enough for it to grow into a new
tumour.When this type of cancer comes back; it can be more
difficult to treat.

These tumors don’t respond all that well to chemotherapy.

This treatment may be used to shrink the tumor, but it is
unlikely to cure it.