Skip to main content

Advertisement

Log in

Schwannoma-Like Pleomorphic Adenoma: Two Cases and a Review of the Literature

  • Original Paper
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Schwannoma-like pleomorphic adenoma is a rare variant of the common benign salivary neoplasm, pleomorphic adenoma. This entity’s cytomorphology closely mimics a schwannoma, potentially making a diagnosis of cytologic preparations or of surgical specimens a challenge. To the best of our knowledge, there are only six previous reports of schwannoma-like pleomorphic adenoma with eight total cases in the English language literature prior to the addition of the two cases detailed in this report. Our report includes what we believe to be the first documented case of this entity occurring in the submandibular gland. One of our cases occurred in the submandibular gland of a 90-year-old woman and the other occurred in the left parotid gland of a 40-year-old woman. We also examine the diagnostic considerations used to differentiate these two entities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Tille JC, Reychler H, Hamoir M, Schmitz S, Weynand B. Schwannoma-like pleomorphic adenoma of the parotid. Rare Tumors. 2011;3(4):e40.

    Article  Google Scholar 

  2. Eveson JW, Cawson RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age, and sex distribution. J Pathol. 1985;146:51–8.

    Article  CAS  Google Scholar 

  3. Seifert G, Donath K, Schafer R. Lipomatous pleomorphic adenoma of the parotid gland. Classification of lipomatous tissue in salivary glands. Pathol Res Pract. 1999;195:247–52.

    Article  CAS  Google Scholar 

  4. Di Palma S. Carcinoma ex pleomorphic adenoma, with particular emphasis on early lesions. Head Neck Pathol. 2013;7(suppl 1):S68–76.

    Article  Google Scholar 

  5. Richmon JD, Wahl CE, Chia S. Coexisting facial nerve schwannoma and monomorphic adenoma of the parotid gland. Ear Nose Throat J. 2004;83(3):166–9.

    Article  Google Scholar 

  6. Gross B, Carlson M, Moore E. The intraparotid facial nerve schwannoma: a diagnostic and management conundrum. Am J Otolaryngol. 2012;33(5):497–504.

    Article  Google Scholar 

  7. Kim YC, Park HJ, Cinn YW, Vandersteen DP. Benign glandular schwannoma. Br J Dermatol. 2001;145(5):834–7.

    Article  CAS  Google Scholar 

  8. Ducatman B, Scheithaur B. Malignant peripheral nerve sheath tumors with divergent differentiation. Cancer. 1984;54:1049.

    Article  CAS  Google Scholar 

  9. Tarjan G. Schwannoma including epithelial elements mimicking pleomorphic adenoma of the submandibular gland on fine-needle cytology: the first case report. Diagn Cytopathol. 2015;43:395.

    Article  Google Scholar 

  10. Holliday AC, Mazloom SE, Coman GC, Kolodney MS, Chavan RN, Grider DJ. Benign glandular schwannoma with ancient change. Am J Dermatopathol. 2016. https://doi.org/10.1097/DAD.0000000000000739.

    Article  PubMed  Google Scholar 

  11. Kapila K, Mathur S, Verma K. Schwannomas: a pitfall in the diagnosis of pleomorphic adenomas on fine-needle aspiration cytology. Diagn Cytopathol. 2002;27(1):53–9.

    Article  Google Scholar 

  12. Takeda Y, Shimono M. Pleomorphic adenoma with nuclear palisading of modified myoepithelial cells: histopathologic and immunohistochemical study. Bull Tokyo Dent Coll. 1999;40(1):27–34.

    Article  CAS  Google Scholar 

  13. Rossi ED, Faquin WC, Baloch Z, et al. The Milan System for Reporting Salivary Gland Cytopathology: analysis and suggestions of initial survey. Cancer Cytopathol. 2017;125:757–66.

    Article  Google Scholar 

  14. Chandra SR, Karim F, Yeshwant BR. Divergent schwannoma-like phenotype in a pleomorphic adenoma. Head Neck Pathol. 2017;11(4):567–74.

    Article  Google Scholar 

  15. Matsuyama A, Hisaoka M, Hasimoto H. PLAG1 expression in mesenchymal tumors: an immunohistochemical study with special emphasis on the pathogenetical distinction between soft tissue myoepithelioma and pleomorphic adenoma of the salivary gland. Pathol Int. 2012;62(1):1–7.

    Article  CAS  Google Scholar 

  16. Merino MJ, LiVolsi VA. Pleomorphic adenomas of the parotid gland resembling mesenchymal tumors. Oral Surg Oral Med Oral Pathol. 1977;44(3):405–10.

    Article  CAS  Google Scholar 

  17. Kajor M, Gierek T, Markowski J, Pajak J. Schwannomalike mixed tumor of the parotid gland: a case report. Acta Cytol. 2006;50(5):529–30.

    Article  Google Scholar 

  18. Lombardi M, Socciarelli F, Finin G, Leonardi A, Bartolazzi A. Schwannoma-like pleomorphic adenoma: a case report with review of the literature. Head Neck Pathol. 2014;8(2):178–81.

    Article  Google Scholar 

  19. Jo VY, Fletcher CD. p63 immunohistochemical staining is limited in soft tissue tumors. Am J Clin Pathol. 2011;136(5):762–6.

    Article  Google Scholar 

  20. Fehlings MG, Nater A, Zamorano JJ, Tetreault LA, Varga PP, Gokaslan ZL, et al. Risk factors for recurrence of surgically treated conventional spinal schwannomas: analysis of 169 patients from a multicenter international database. Spine. 2016;41(5):390–8. https://doi.org/10.1097/BRS.0000000000001232.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Zernial O, Springer IN, Warnke P, et al. Long-term recurrence rate of pleomorphic adenoma and postoperative facial nerve paresis (in parotid surgery). J Craniomaxillofac Surg. 2007;35:189–92.

    Article  Google Scholar 

  22. Abe M, et al. A case of pleomorphic adenoma of the parotid gland with multiple local recurrences through facial to cervical regions. Open J Stomatol. 2014;4:441–5.

    Article  Google Scholar 

  23. Redaelli de Zinis LO, Piccioni M, Antonelli AR, Nicolai P. Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature. Eur Arch Otorhinolaryngol. 2007;265(4):447–52.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge Dr. Kasturi Das, MD for her assistance with the cytopathologic interpretation of these cases.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen H. Roth.

Ethics declarations

Conflict of interest

The authors have nothing to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Roth, S.H., Faquin, W.C., Gimenez, C. et al. Schwannoma-Like Pleomorphic Adenoma: Two Cases and a Review of the Literature. Head and Neck Pathol 14, 166–172 (2020). https://doi.org/10.1007/s12105-019-01036-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-019-01036-y

Keywords

Navigation