Kwon Young-Eun
Department of Oral and Maxillofacial Radiology, Kyungpook National University Dental Hospital, Daegu, Korea.
Imaging Sci Dent. 2023 Sep;53(3):239-245. doi: 10.5624/isd.20230504. Epub 2023 Sep 4.
Schwannomas are uncommon neoplasms of neurologic origin that are rare in the salivary glands. A schwannoma that persists for a long time is referred to as an ancient schwannoma if it is accompanied by degenerative changes on histology. The case described herein involved a 37-year-old man with an ancient schwannoma that had persisted for 20 years in his right parotid gland. Clinically, the lesion presented with swelling and pain. Computed tomography revealed a well-defined, multilocular enhanced lesion. T2-weighted magnetic resonance images displayed multilocular hyperintensity, while T1-weighted images showed a high signal at the lobulated margin and a homogeneous low signal internally. The preoperative diagnosis, based on the lesion's location and imaging diagnosis, was Warthin's tumor. However, a biopsy conducted after surgical excision identified the lesion as a schwannoma with cystic degeneration. This report also presents a summary of the characteristics of rare cases of schwannoma in the major salivary gland based on this case and a literature review.
施万细胞瘤是起源于神经的罕见肿瘤，在唾液腺中极为少见。如果一个施万细胞瘤持续存在很长时间，并且在组织学上伴有退行性改变，那么它就被称为陈旧性施万细胞瘤。本文所述病例为一名37岁男性，其右侧腮腺内有一个已持续20年的陈旧性施万细胞瘤。临床上，该病变表现为肿胀和疼痛。计算机断层扫描显示一个边界清晰的多房性强化病变。T2加权磁共振图像显示多房性高信号，而T1加权图像显示分叶状边缘为高信号，内部为均匀低信号。基于病变位置和影像学诊断，术前诊断为沃辛瘤。然而，手术切除后进行的活检确定该病变为伴有囊性变的施万细胞瘤。本报告还基于该病例及文献复习，总结了大唾液腺中罕见施万细胞瘤病例的特征。
