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A rare histopathological variant of Schwannoma with rosette-like arrangements and epithelioid cells: a case report from a histopathologist’s perspective

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2023, v.49 no.4, pp.233-238
https://doi.org/10.5125/jkaoms.2023.49.4.233
Mehendiratta Monica (Department of Oral and Maxillofacial Pathology, I.T.S Dental College, Hospital)
Sant Vikas Kumar (Department of Oral and Maxillofacial Pathology, Sudha Rustagi College of Dental Sciences)
Lakhanpal Manisha (Department of Oral and Maxillofacial Pathology, I.T.S Dental College, Hospital)
Chauhan Keerti (Department of Oral and Maxillofacial Pathology, I.T.S Dental College, Hospital)

Abstract

Schwannomas exhibit histopathological variation that leads to diagnostic dilemmas, although less frequent in the oral cavity. We describe a case with unique histopathology and no relevant clinical history that adds to the breadth of literature on the diversity presented by Schwannoma. A 60-year-old female patient presented with a small dome-shaped, asymptomatic swelling on the alveolar ridge 6 years in duration. Histopathologically, it showed rich cellular pathology with a unique arrangement of tumor cells forming irregular rosettes. Each rosette presented with a central core of fibrincollagenous material and the tumor cells were arranged on the periphery, exhibiting epithelioid change with evidence of mild cellular and nuclear pleomorphism. On immunohistochemical evaluation, the cells were strongly and diffusely positive for S-100 and negative for Ki-67. A diagnosis of benign Schwannoma with a rosette-like arrangement with epithelioid change was made. The case report emphasizes the risk of misdiagnosis and the importance of awareness regarding rare histopathological variants of Schwannoma.

keywords
Epithelioid cells, Verocay bodies, Neurilemmoma, Collagen, Rosette

Journal of the Korean Association of Oral and Maxillofacial Surgeons