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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2019; 23(03): e354-e359
DOI: 10.1055/s-0039-1692404
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Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Trans-oral, Carbon Dioxide-Assisted Excision of an Unusual Schwannoma of the Tongue Base: Case Report and Review of the Literature

Zakaria Raee Soliman
1   Oto-Rhino-Laryngology-Head and Neck (ORL-HN) Surgery, Military Medical Academy Ringgold Standard Institution, Cairo, Egypt
,
Mohammad Kamal Mobashir
2   ORL-HN Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
,
Sherif Mohammad Askar 
3   ORL-HN Surgery, Zagazig University, Zagazig, Egypt
› Author Affiliations
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Publication History

06 October 2018

08 May 2019

Publication Date:
26 July 2019 (online)

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Abstract

Introduction Schwannomas are benign, solitary, encapsulated tumors that may originate at any site of the peripheral nervous system, with the exception of the olfactory and optic nerves. Schwannomas of the base of tongue are very rare, and only sporadic cases are documented. The tongue base represents a challenge for surgeons. Carbon dioxide (CO2) laser might provide an effective surgical option for such lesions because of the easy access to the lesion, the bloodless surgical field and optimum epithelization of wounds.

Objective We present an unusual case of pedunculated schwannoma of the tongue base treated via transoral CO2-assisted excision. We also provide a review of the available literature, in English language, on humans.

Data synthesis The authors searched the PubMed database and Google up to July 2018. The following search terms were applied: tongue and lingual, combined with schwannoma and neurilemmoma. Titles and abstracts were screened, and, then, only supraglottic (hypopharyngeal) tongue base masses were considered. Fourteen articles were included in this review, reporting 17 cases. The age of the patients ranged from 9 to 39 years, affecting predominantly females. Dysphagia and lump sensations were the most common presenting symptoms, and the mean follow-up period range was 1.5 to 60 months (mean = 13 months). There was no evidence of recurrence in any of the cases.

Conclusion We could conclude that tongue base schwannomas are rare. Transoral complete excision of the tumor is the treatment of choice. CO2 laser surgery is a minimally invasive treatment option that has been performed in few reports with no recurrence and with favorable outcomes.

Keywords

carbon dioxide laser - tongue base schwannoma - deglutition disorders - deglutition
 

  • References

  • 1 Kapadia SB. Tumors of the nervous system. In: Barnis L. , ed. Surgical Pathology of the Head and Neck. Vol. 2, 2nd ed. NewYork, NY: Marcel Dekker Inc; 2000: 795-798
    Google Scholar
  • 2 Gooder P, Farrington T. Extracranial neurilemmomata of the head and neck. J Laryngol Otol 1980; 94 (02) 243-249
    CrossrefPubMedGoogle Scholar
  • 3 Jadwani S, Bansod S, Mishra B. Intraoral schwannoma in retromolar region. J Maxillofac Oral Surg 2012; 11 (04) 491-494
    CrossrefPubMedGoogle Scholar
  • 4 Sawhney R, Carron MA, Mathog RH. Tongue base schwannoma: report, review, and unique surgical approach. Am J Otolaryngol 2008; 29 (02) 119-122
    CrossrefPubMedGoogle Scholar
  • 5 Chandra M, Singh P, Venkatchalam VP. Tongue Schwannoma: A case report with review of literature. JK Pract 2013; 18 (1–2): 28-34
    Google Scholar
  • 6 Huang CM, Leu YS. Schwannoma of the posterior pharyngeal wall. J Laryngol Otol 2002; 116 (09) 740-741
    CrossrefPubMedGoogle Scholar
  • 7 Arda HN, Akdogan O, Arda N, Sarikaya Y. An unusual site for an intraoral schwannoma: A case report. Am J Otolaryngol 2003; 24 (05) 348-350
    CrossrefPubMedGoogle Scholar
  • 8 Hsu YC, Hwang CF, Hsu RF, Kuo FY, Chien CY. Schwannoma (neurilemmoma) of the tongue. Acta Otolaryngol 2006; 126 (08) 861-865
    CrossrefPubMedGoogle Scholar
  • 9 Lira RB, Gonçalves Filho J, Carvalho GB, Pinto CA, Kowalski LP. Lingual schwannoma: case report and review of the literature. Acta Otorhinolaryngol Ital 2013; 33 (02) 137-140
    PubMedGoogle Scholar
  • 10 Mehrzad H, Persaud R, Papadimitriou N, Kaniyur S, Mochloulis G. Schwannoma of tongue base treated with transoral carbon dioxide laser. Lasers Med Sci 2006; 21 (04) 235-237
    CrossrefPubMedGoogle Scholar
  • 11 Cohen M, Wang MB. Schwannoma of the tongue: two case reports and review of the literature. Eur Arch Otorhinolaryngol 2009; 266 (11) 1823-1829
    CrossrefPubMedGoogle Scholar
  • 12 George NA, Wagh M, Balagopal PG, Gupta S, Sukumaran R, Sebastian P. Schwannoma base tongue: Case report and review of literature. Gulf J Oncolog 2014; 1 (16) 94-100
    PubMedGoogle Scholar
  • 13 de Bree R, Westerveld GJ, Smeele LE. Submandibular approach for excision of a large schwannoma in the base of the tongue. Eur Arch Otorhinolaryngol 2000; 257 (05) 283-286
    CrossrefPubMedGoogle Scholar
  • 14 Dreher A, Gutmann R, Grevers G. [Extracranial schwannoma of the ENT region. Review of the literature with a case report of benign schwannoma of the base of the tongue]. HNO 1997; 45 (06) 468-471
    PubMedGoogle Scholar
  • 15 Triaridis C, Tsalighopoulos MG, Kouloulas A, Vartholomeos A. Posterior pharyngeal wall schwannoma (case report). J Laryngol Otol 1987; 101 (07) 749-752
    CrossrefPubMedGoogle Scholar
  • 16 Spandow O, Fagerlund M, Bergmark L, Boquist L. Clinical and histopathological features of a large parapharyngeal neurilemmoma located at the base of the tongue. ORL J Otorhinolaryngol Relat Spec 1999; 61 (01) 25-30
    CrossrefPubMedGoogle Scholar
  • 17 Nakasato T, Kamada Y, Ehara S, Miura Y. Multilobular neurilemmoma of the tongue in a child. AJNR Am J Neuroradiol 2005; 26 (02) 421-423
    PubMedGoogle Scholar
  • 18 López-Jornet P, Bermejo-Fenoll A. Neurilemmoma of the tongue. Oral Oncology Extra 2005; 41 (07) 154-157
    CrossrefGoogle Scholar
  • 19 Ying YL, Zimmer LA, Myers EN. Base of tongue schwannoma: a case report. Laryngoscope 2006; 116 (07) 1284-1287
    CrossrefPubMedGoogle Scholar
  • 20 Batra K, Rai AK, Chaudhary N, Topno S. Two cases of neurilemmoma of the tongue. Ear Nose Throat J 2007; 86 (11) 679-681
    CrossrefPubMedGoogle Scholar
  • 21 Ballesteros F, Vilaseca I, Blanch JL, Gaspa A, Bernal-Sprekelsen M. Base of tongue neurilemmoma: excision by transoral laser microsurgery. Acta Otolaryngol 2007; 127 (09) 1005-1007
    CrossrefPubMedGoogle Scholar
  • 22 Monga S, Malik JN, Sharma AP. Schwannoma tongue. JCR 2013 http://dx.doi.org/10.17659/01.2013.0052
    CrossrefGoogle Scholar
  • 23 Jayaraman V, Balasubramanian B, Senthivelu R. Schwannoma of the tongue—a rare clinical entity. IJDSR 2013; 1 (03) 53-55
    Google Scholar
  • 24 Sitenga JL, Aird GA, Nguyen A, Vaudreuil A, Huerter C. Clinical features and surgical treatment of schwannoma affecting the base of the tongue: A systematic review. Int Arch Otorhinolaryngol 2017; 21 (04) 408-413
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Kamath MP, Kini H, Shenoy SV, Deviprasad D, Prakash N, Pai R. Schwannoma of the base of tongue – A rare presentation. Egyptian J Ear Nose Throat Allied Sci 2014; 15: 61-64
    Google Scholar
  • 26 Villarreal Renedo PM, Monje Gil F, Junquera Gutiérrez LM, De Vicente Rodríguez JC, Morillo Sánchez AJ. Treatment of oral and oropharyngeal epidermoid carcinomas by means of CO2 laser. [Article in English, Spanish]. Med Oral 2004; 9 (02) 172-5 , 168–72
    PubMedGoogle Scholar
  • 27 Roy P, Chakraborty S, Das S, Roy A. Solitary Neurofibroma at the Base of the Tongue: A Rare Presentation. Indian J Dermatol 2015; 60 (05) 497-499 . Doi: 10.4103/0019-5154.16437
    CrossrefPubMedGoogle Scholar
  • 28 Badar Z, Farooq Z, Zaccarini D, Ezhapilli SR. Tongue base schwannoma: differential diagnosis and imaging features with a case presentation. Radiol Case Rep 2016; 11 (04) 336-340
    CrossrefPubMedGoogle Scholar
  • 29 Sharma S, Rai G. Schwannoma (Neurilemmoma) on the Base of the Tongue: A Rare Clinical Case. Am J Case Rep 2016; 17 (17) 203-206
    CrossrefPubMedGoogle Scholar