Isolated Infra-Orbital Nerve Schwannoma

Abstract

Introduction- A schwannoma is a benign tumor that develops from Schwann cells. It’s known to occur more frequently in women than men, and about one third occur in the head & neck area. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are rare. Case report- A 24-year-old male jute mill worker presented with painless swelling over left side of face for the last 12 years. On examination, localized, nontender, firm 3cm x 3cm swelling was found over left maxilla. Computed Tomography scan showed a well-defined heterogenous oval mass over the left maxilla extending over infraorbital foramen. Aspiration cytology of lesion showed good numbers of spindle cells in groups and dispersedly with fibrous strands. Diagnosis of schwannoma probably arising from terminal branch/trunk of infraorbital nerve was made. Surgical excision of lesion was done under general anesthesia. Histopathological examination of the excised lesion showed grossly firm and gray mass. Microscopically the lesion showed admixture of dense and loose areas referred to as Antoni A and Antoni B areas respectively. Discussion- Infraorbital nerve schwannoma is a possible diagnosis in case of a swelling over the maxilla.

Keywords

• Schwannoma
• Infraorbital nerve
• Schwann cells
• Neurofibromatosis
• Extra-cranial schwannoma
• Midface swelling