PMC3162851_01
Swelling in the right buccal vestibule with displacement of second premolar
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F1
Intraoral examination revealed a diffuse swelling in the mandibular right buccal vestibule, extending from the canine up to the first molar, measuring 2.5 x 1 cm in size. [Figure 1] The surface appeared smooth and the surrounding area normal.
Cross-sectional occlusal radiograph showing bicortical expansion caused by the tumor
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F2
Cross sectional occlusal radiograph showed bicortical expansion extending from the distal line angle of the canine up to the mesial aspect of the second molar tooth [Figure 2].
Cropped panoramic radiographic image showing the tumor extending from the right fi rst premolar up to the second molar
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F3
Photomicrograph showing the bundles of spindle cells in Antoni A and Antoni B zones, arranged in palisading pattern, interspersed with the verocay bodies (H and E, 10x)
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F4
The incisional biopsy specimen showed an unencapsulated lesion consisting of bundles of spindle cells in Antoni A and Antoni B zones arranged in a palisading pattern, interspersed with small hyaline structures, the Verocay bodies [Figure 4, Figure 5].
Photomicrograph, showing spindle cells with verocay bodies (H and E, 40x)
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F5
The incisional biopsy specimen showed an unencapsulated lesion consisting of bundles of spindle cells in Antoni A and Antoni B zones arranged in a palisading pattern, interspersed with small hyaline structures, the Verocay bodies [Figure 4, Figure 5].
Immunohistochemistry with S-100 showing diffuse positivity in the tumor cells (S-100, 10x)
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F6
Immunohistochemistry was performed with an S-100 marker, which showed diffuse positivity in the tumor cells [Figure 6], which further potentiated the diagnosis of Schwannoma.
Tumor exposed surgically
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F7
Treatment encompassed segmental resection of the tumor, with reconstruction using autogenous iliac crest bone graft, under general anesthesia, at the Department of Oral and Maxillofacial Surgery [Figure 7].