PMC5502503_01
(a) Intraoral picture showing well-defined soft tissue mass in the right posterior buccal mucosa. (b) Contrast-enhanced computed tomography in axial sections showing 3.05 cm x 2.62 cm round, hypodense lesion in the right retromaxillary region. (c) Completely excised tumor mass. (d) Bundles of palisading cells with buckled nuclei (H and E, x10)
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PMC5502503_01_AMS-7-140-g001.jpg
F1
Intraoral examination revealed a 2 cm x 2 cm, sessile, firm, nontender, nonulcerated mass on the right posterior buccal mucosa [Figure 1a]. There was no definite erosion/destruction of the underlying bone [Figure 1b]. The entire mass was excised in toto [Figure 1c] and was sent for histopathological examination. The tumor consisted predominantly Antoni B pattern; bundles of palisading cells were seen with buckled nuclei [Figure 1d].
PMC5502503_02
(a) Intraoral swelling in right maxillary vestibule. (b and c) Magnetic resonance imaging in axial and coronal section showing 6 cm x 4.5 cm well-defined lobulated heterogeneously enhancing lesion with solid as well as necrotic component in right infratemporal region. (d) Lesional tissue showing S-100 positivity. (e) Completely excised tumor mass. (f) Areas of hyalinization and myxoid change with peripherally placed nuclei (H and E, x10). Thick blood vessels with hyalinization and perivascular inflammation were noted with cystic changes and fibrin deposition
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PMC5502503_02_AMS-7-140-g002.jpg
F2
There was no bleeding or ulceration of the surface [Figure 2a]. Magnetic resonance imaging of the patient in coronal and axial section [Figure 2b and 2c] revealed a 6 cm x 4.5 cm well-defined lobulated heterogeneously enhancing lesion with solid as well as necrotic component in the right infratemporal region. All lesional cells were positive for S-100 antibody [Figure 2d]. With intraoral approach, incision in right maxillary vestibule and palate was made and osteotomy of the maxilla was done to access and expose the tumor, which was removed completely [Figure 2e]. The overall histo-architecture was consistent with diagnosis of ancient schwannoma [Figure 2f].