On palpation, it was firm and tender. Computed tomography (CT) scans (axial view) showed a well-defined heterodense mass measuring 3.5 �� 2.5 �� 2.5 cm, with specks of calcification in the right sublingual region. There was a hypodense rim around the swelling causing smooth erosion of the adjacent mandible. No evidence of cortical irregularity or periosteal reaction was found. Furthermore, selleck products multiple enlarged, submental and bilateral submandibular lymph nodes were seen [Figure 1]. Figure 1 Computed tomography scan in axial view showed a well-defined heterodense mass with specks of calcification in the right sublingual region Based on the clinical findings, the CT scan features and anatomical location a provisional diagnosis of salivary gland tumor involving sublingual gland was given.

The patient underwent surgical excision of the mass under general anesthesia; the post-surgical course was uneventful. Macroscopically, the resected mass was encapsulated, greyish-white in color, measuring 4 �� 4 �� 3 cm. It was oval, smooth and firm in consistency [Figure 2]. Microscopic examination revealed a well encapsulated tumor exhibiting areas of organized spindle-shaped cells in palisading arrangement around acellular, eosinophilic areas forming Verocay bodies giving Antoni type ��A�� pattern. Other areas with Antoni type ��B�� pattern exhibited less cellularity, less organized cells, which were plump, spindle-shaped and were generally seen adjacent to densely vascular areas [Figure 3]. Immunohistochemical investigation of the tumor cells showed diffuse, strongly positive staining for S-100 protein [Figure 4].

These findings were compatible with the diagnosis of Schwannoma. Figure 2 Gross appearance of the resected tumor mass Figure 3 Depicts Antoni type ��A�� tissue with spindle-shaped cells, palisading nuclei and Verocay bodies, (H and E, ��10) Figure 4 Immunohistochemical staining of the tumor cells showing diffuse, strong positivity for S-100 protein, (��10) DISCUSSION Neurilemoma/Schwannoma, is a benign tumor arising from and consisting solely of Schwann cells.[1,4] It ranges from a few millimeters to several centimeters in size.[2] It affects the genders in roughly equal numbers.[5] Extracranially, about a quarter of all Schwannomas occur in the head and neck region. Only 1% of these show an intraoral origin.[4,6,7] Intraorally, the tongue is the most common location.

[3] Schwannomas are usually solitary lesions; however, some are seen as multiple lesions as part of Neurofibromatosis type Anacetrapib I.[1] The solitary neurilemoma is a slow growing, encapsulated tumor that typically arises in association with a nerve trunk. As it grows it pushes the nerve aside. Usually the mass is asymptomatic, although tenderness or pain may occur in some instances.[2] In the present case the Schwannoma presented as an asymptomatic, enlarging, well circumscribed mass in the right anterior floor of the mouth in a 28-year-old male.