Schwannoma with an Uncommon Upper Lip Location and Literature Review

Schwannomas are usually single, encapsulated, and benign tumors of the nerve sheath that arise from the perineural Schwann cells. Schwannomas are mostly seen in the fourth decade. Despite its location in the head and neck region is 25–45%, lip location of schwannoma are very rare. We present a case of a upper lip schwannoma in the pediatric age and review the literature. 1. Introduction Schwannomas or neurilemmomas are especially single, encapsulated, and benign tumors of the nerve sheath that arise from the perineural Schwann cells. Approximately 25–45% of all schwannomas are seen in the head and neck region [1–5]. In the head and neck region, the tumor generally appears in the tongue. Tumor can be less frequently seen in the palate, floor of the mouth, gingiva, and buccal mucosa, parotid gland as well [3, 6, 7]. Upper lip location of the Schwannoma is very rare. It is usually seen in the fourth decade of life [1, 2]. In the literature there is only one reported upper lip schwannoma in the pediatric age group [8]. Schwannoma of the upper lip in a 15-year-old boy is reported with the review of the literature. 2. Case Report A 15-year-old boy referred to Otorhinolaryngology Department of the Inonu University Medical Faculty with a painless mass on the left side of his upper lip. In physical examination, a painless mass of located in the left portion of upper lip which was mobile, oval shaped, and had smooth surface was revealed. There was neither associated medical findings nor family history about any other concomitant diseases such as neurofibromatosis. He reported no trauma history to the region, as well. The clinical presentation of the mass indicated a benign lesion. The mass was followed up for two years due to the decision of the patient’s parents. During the two-year follow-up period, subsequent physical examinations revealed approximately one mm growth of the mass. After two-year follow-up period, the parents consented the mass to be surgically removed. The differential diagnosis included a salivary gland tumor, neurofibroma, or nasolabial cyst. The total excision of the mass was performed under local anesthesia, and the specimen was examined histopathologically. The gross evaluation of the specimen was noted as an encapsulated homogenous mass of including fibrous connective tissue. The histopathological examination of the excisional biopsy showed an encapsulated cellular mesenchymal tumor that is composed of spindle cells (Figure 1). There was a uniform cellular apperance (Antoni A pattern) through out the tumor without hypocellular areas