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25 June 2010

Excision of a tongue schwannoma with the Harmonic Scalpel®: Bloodless and harmless

Luca Guastini, Renzo Mora, Massimo Dellepiane, Angelo Salami

Am J Case Rep 2010; 11:119-122 :: ID: 880907


Background: A schwannoma, also called neurilemmoma, is a benign encapsulated slow-growing tumor arising from the neural sheath’s Schwann cells of the peripheral, cranial, or autonomic nerves. Schwannoma of the tongue is uncommon, but the treatment is simple. However, the diagnosis is invariably delayed because of the vagueness of symptoms. The aim of this paper was to evaluate the benefits and risks when using the Harmonic Scalpel® (HS) in the excision of a lingual schwannoma involving the left lateral border of the tongue.
Case Report: A 24-year-old female patient presented with a five-month history of swelling, associated with pain, at the left lateral border of the tongue. Intraoral examination showed an elastic, non-tender, smooth, visible, and well-demarcated mass of 12×13×6 mm on the lateral margin of the tongue. No lymph nodes were enlarged and the remainder of the head and neck examination revealed no other lesions. The lesion was excised with a small border of clinically uninvolved surrounding tissue intraorally with the HS. Macroscopically, the entire lesion was removed with its capsule. Histopathological examination of a surgical specimen showed a schwannoma. The postoperative course was uneventful. The patient has been followed up for two years and there has been no evidence of recurrence.
Conclusions: The use of the HS was simple, harmless, and bloodless, with satisfactory wound healing. We feel that the HS is an excellent choice when faced with a schwannoma or other masses located at the tongue.

Keywords: harmonic scalpel, schwannoma, Tongue

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923