European Journal of Scientific Research - EuroJournals

Sublingual Schwannoma in a Nigerian African-a Case Report 435
Sonography is the first line imaging modality in assessment of salivary glands. Due to their
superficial position, the parotid, the submandibular, and the sublingual glands can be imaged with
high- resolution transducers.
Sonography enables the diagnosis of cysts or ranulae. Schwannoma appear as a wellcircumscribed,
circular type mass with smooth margin on images. Tumours of salivary glands can be
visualized with sensitivity but like other imaging techniques (MRI & CT-Scan) the specificity in
assessment of the histology of a tumour is low in many diseases 6 .Schwannoma should be suspected in
the oral floor when a well-circumscribed mass whose margin is smooth shows cystic degeneration on
MRI 4 .
These tumours are usually firm to hard in consistency and on section are often studded with
areas of cystic degenerations, haemorrhage or lipid deposition 8 .Treatment is surgical excision and the
approach depends on the location and the extent of the tumour and long-term follow-up is necessary 3 .
This report is on a case of sublingual swelling found to be a Schwannoma in a young Nigerian
with sonographic findings in a setting with limited diagnostic imaging techniques and a review of the
literature of this rare tumour.
Case Report
O. S. is an 18year old secondary school student who presented July 2002 with a year history of
swelling under the tongue immediately followed by small rashes and ulcers on the dorsum of the
tongue. There was no associated pain, dysphagia or breathlessness. He had oral ampiclox capsules and
paracetamol tablets prescribed in a primary health centre and the rashes and the small ulcers
disappeared. The Sublingual Swelling progressed and three months before presentation, developed
difficulty in mastication and dysphagia due to the elevation of the tongue by the swelling.
Oral cavity examination revealed a sublingual swelling, about 6x 6 cm, mainly to the left of the
frenulum, well circumscribed, firm in consistency, non- tender, non- fluctuant and the mucosa over it
was intact and highly vascularised with restricted tongue protrusion. No palpable submental or
submandibular lymph nodes. No obvious neck swelling. All other systems were essentially normal. A
diagnosis of sublingual dermoid cyst was made with sublingual thyroid and thyroglossal cyst as
differentials.
Sublingual Ultrasound (Fig. I) showed a well-circumscribed sublingual solid mass 6x6cm on
the left side of the frenulum as shown by the arrow and the right side was normal. Neck ultrasound
showed normal thyroid gland. Full blood counts and electrolytes and urea with creatinine were within
normal limits.