Cristofaro Maria Giulia, Giudice Amerigo, Donato Giuseppe, Colangeli Walter, Giudice Mario
Unit of Maxillo-Facial Surgery, University "Magna Grecia", Catanzaro, Italy.
Ann Ital Chir. 2011 May-Jun;82(3):205-9.
The aim of the study is to give an explanation on the Intra-osseous Schwanoma etio-pathogenesis, based on the isto-pathological findings presented by the Authors.
In a 40 years old patient with pain on the territory innervated by the third right trigeminal branch, OPT showed a like ground-glass area that involved the mandible with the mandibular canal disappearance and dental roots resorption. They removed the lesion with preservation of the vascular-neural beam on which the lesion were extremely attached; the histological examination confirmed the diagnosis of intra-osseous Schwannoma. Immunohistochemically the Schwannoma labelled with antibodies to S-100, Vimentin, Osteopontin and Osteonectin. RESULST: The clinical and radiological follow-up after one year since the surgery, using OPT showed an improvement of bone formation and the disappearance of the pain.
Schwannoma rarely presents as an intraosseous mass, comprising less than 1% of all bone tumors with a strong predilection for the mandible. Data like the expression of osteopontin are believed to be distinctive feature of other schwannian cell tumors such as the granular cell tumor. Such data might explain the prevalence of mandibular location among the rare intraosseous schwannomas and might point out that the calcified shwannoma of the skull is similar to an hamartomatous lesion.
本研究旨在根据作者提供的组织病理学发现，对骨内施万瘤的病因发病机制作出解释。
一名40岁患者，右侧三叉神经第三支支配区域疼痛，口腔全景片（OPT）显示下颌骨出现类似磨砂玻璃样区域，下颌管消失，牙根吸收。他们在保留与病变紧密相连的血管神经束的情况下切除了病变；组织学检查证实为骨内施万瘤。免疫组织化学检查显示，施万瘤对S-100、波形蛋白、骨桥蛋白和骨粘连蛋白抗体呈阳性反应。结果：术后一年的临床和放射学随访，口腔全景片显示骨形成改善，疼痛消失。
施万瘤很少表现为骨内肿块，占所有骨肿瘤的比例不到1%，且强烈倾向于发生在下颌骨。像骨桥蛋白表达这样的数据被认为是其他施万细胞肿瘤（如颗粒细胞瘤）的独特特征。这些数据可能解释了罕见的骨内施万瘤中下颌骨部位的高发情况，并可能指出颅骨的钙化施万瘤类似于错构瘤性病变。
