A Case of Ancient Schwannoma in Retromaxillary Area Removed with Le Fort I Osteotomy Approach

ABSTRACT

Schwannoma, which manifests as a smooth and solitary, encapsulated lesion, originates from the nerve sheaths of Schwann cells. Ancient schwannoma, a rare histologic variant of schwannoma, characterized by its distinctive degenerative changes. Basically, treatment entails complete removal of the mass, with maximal safeguarding of the nerve. However, depending on tumor size and extent, complete removal can be problematic. Le Fort I osteotomy in orthognathic surgery is widely utilized and can be effective to remove the skull base tumors. A 25-year-old woman presented with stabbing pain of 1-2 seconds duration occurring every two hours in the interior of the right face, which condition had persisted for one year. Magnetic resonance imaging showed mass lesion in the right retromaxillary area. Mass in retromaxillary area was removed by Le Fort I osteotomy. Pathologic examination confirmed the diagnosis of ancient schwannoma. In the course of a six-month follow-up, neither recurrence nor malocclusion was observed.