Sittisak Nuttawut, Kiatmontri Jinatta, Uaangkanon Sumet, Sirimahachaiyakul Pornthep
General Practitioner, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Sisaket Hospital, Sisaket, Thailand.
BMJ Case Rep. 2025 Jan 21;18(1):e261615. doi: 10.1136/bcr-2024-261615.
Schwannomas, benign tumours derived from Schwann cells, exhibit slow growth rates and are commonly found extracranially in the head, neck and extremities. However, intraoral and salivary gland schwannomas are less frequent. Ancient schwannomas, characterised by histological degenerative changes, represent a rare variant.This report pertains to a case study involving a man in his 40s who presented with a slow, progressive and painless mass in the right submandibular region persisting over 3 years.CT revealed a well-defined multiloculated cystic mass in the right submandibular gland, later confirmed as an ancient schwannoma on excision and histological examination. Immediate postoperative complications included right marginal mandibular nerve palsy, fully resolving within 12 months. No recurrent tumours were detected in subsequent physical examinations and imaging.Ancient schwannomas, although rare, can occur in the submandibular gland. Thorough multimodal diagnostic approaches are essential for accurate differentiation from other submandibular masses.
施万细胞瘤是源自施万细胞的良性肿瘤，生长速度缓慢，常见于颅外的头、颈和四肢。然而，口腔内和涎腺施万细胞瘤较为少见。具有组织学退行性改变特征的陈旧性施万细胞瘤是一种罕见的变异类型。本报告涉及一例40多岁男性病例，其右侧下颌下区出现缓慢、进行性且无痛性肿块，持续超过3年。CT显示右侧下颌下腺有一个边界清晰的多房囊性肿块，切除及组织学检查后确诊为陈旧性施万细胞瘤。术后即刻并发症包括右侧下颌缘支神经麻痹，在12个月内完全恢复。后续体格检查和影像学检查未发现复发性肿瘤。陈旧性施万细胞瘤虽然罕见，但可发生于下颌下腺。全面的多模式诊断方法对于准确鉴别其他下颌下肿块至关重要。
