Intraosseous Ancient Schwannoma of the Mandible-A Case Report

Ancient schwannoma is a unique variant of schwannoma grossly and microscopically characterized by its large size and degenerative changes. Intraosseous ancient schwannoma is extremely rare in the head and neck region We report a 22-year-old male patient with intraosseous ancient schwannoma of the mandible. Clinical and radiographic examinations showed an extremely large radiolucent lesion in the right mandibular body with associated root resorption and cortical expansion. Histological and immunohistochemical findings confirmed the diagnosis of ancient schwannoma arising from right inferior alveolar nerve. Treatment encompassed segmental resection of the right mandible and reconstruction with double-barrel fibular osteoseptocutaneous flap. In conclusion, careful clinical and pathological differential diagnosis is essential to confirm the diagnosis of intraosseous ancient schwannoma. We recommend wide excision to treat the type of aggressive and large tumors as seen in the reported case.