Ancient Schwannoma of the Infratemporal Fossa: A Case Report

Document Type : Case Report


1 Department of Pathology and laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

2 Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.


Ancient schwannoma of infratemporal fossa arising from the trigeminal nerve is very rare in clinical practice.
Case Report:
A 65-year old male presented to the outpatient department with a progressive swelling over the left parotid for 5 years and pain during chewing for 6 months which was diagnosed as benign spindle cell tumour on cytology. The tumor was excised with a combined transparotid and transmandibular cervical approach and the final pathology was confirmed to an Ancient Schwannoma.
A giant infratemporal fossa Schwannoma extending to the parapharyngeal space masquerading as a parotid swelling is very unusual. Transparotid transmandibular excision of the infratemporal fossa tumor is an effective approach ensuring complete removal of the tumor with minimal postoperative complications and acceptable cosmoses.


  1. Nager GT. Neurinomas of the trigeminal nerve. Am J Otolaryngol.1984;5(5):301-33.
  2. Gooder P, Farrington T. Extracranial neurilemmomata of the head and neck. J LaryngolOtol. 1980; 94:243–249.
  3. Bradley N, Bowerman JE. Parapharyngeal neurilemmomas. Br J Oral MaxillofacSurg. 1989; 27:139–146.
  4. Kragh LV, Soule EM, Masson JK (1960) Benign and malignant neurilemomas of the head and neck. Surg Gynecol Obstet. 1960; 111:211–218.
  5. Arena S, Hilal EY. Neurilemomas of the infratemporal space. Report of a case and review of literature. Arch Otolaryngol. 1976; 102:180–184.
  6. Ackerman LV, Taylor FH. Neurogenous tumors within the thorax; a clinicopathological evaluation of forty-eight cases. Cancer. 1951;4:669–91. 
  7. Rengachary SS, McMahon M, Bigongiari LR, Ketcherside J, Gunter K. Neurofibroma of the infratemporal fossa: case report and technical note. Neurosurgery. 1982; 11:43–47.
  8. DasGupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign solitary schwannomas (neurilemmomas). Cancer. 1969; 24:355–366.
  9. Gore DO, Rankow R, Hanford JM. Parapharyngeal neurilemoma. SurgGynecolObstet. 1956; 103:193–201.
  10. Nakayama H, Gobara R, Shimamoto F, Kajihara H. Ancient schwannoma of the oral floor and ventricular portion of the tongue: A case report and review of the literature. Jpn J ClinOncol. 1996; 26:185–8. 
  11. Humber CC, Copete MA, Hohn FI. Ancient schwannoma of upper lip: Case report with distinct histologic features and review of the literature. J Oral Maxillofac Surg. 2011;69:e118–22. 
  12. Huang YF, Kuo WR, Tsai KB.Ancient schwannoma of the infratemporal fossa. J Otolaryngol. 2002; 31:236–8. 
  13. Conley JJ. Tumors of the infratemporal fossa. Arch Otolaryngol. 1964;79:498–504. 
  14. Dayan D, Buchner A, Hirschberg A. Ancient neurilemmoma (schwannoma) of the oral cavity. J Craniomaxillofac Surg. 1989;17:280–2. 
  15. Erlandson RA. Peripheral nerve sheath tumors.UltrastructPathol.1985;9:113‑22.
  16. Cherrick HM, Eversole LR. Benign neural sheath neoplasm of the oral cavity.Report of thirty-seven cases. Oral Surg Oral Med Oral Pathol. 1971;32:900–9.
  17. López JI, Ballestin C. Intraoral schwannoma. A clinicopathologic and immunohistochemical study of nine cases. Arch AnatCytolPathol 1993;41:18‑23.
  18. Dahl I. Ancient neurilemmoma (schwannoma) ActaPatholMicrobiolScand A. 1977; 85:812–8. 
  19. Lambade PN, Palve D, Lambade D. Schwannoma of the cheek: Clinical case and literature review. J Maxillofac Oral Surg 2015; 14:327‑31.
  20. Gupta AK1Singh IMann SBBanerjee AK. Schwannoma of infratemporal fossa in a young child. Indian J Pediatr.1997;64(1):108-11.