Neurilemmoma Masquerading as Tonsillitis: A Case Report 1092-1094
24, Lane 5, Gopal Nagar,
Majitha Road, Amritsar-143001, Punjab, India.
Neurilemmoma, also known as schwannoma, is a benign neoplasm which originates from the Schwann cells which cover the myelinated nerve fibres. The most common site is the tongue while palatal schwannomas are even rarer. A case of schwannoma which was clinically diagnosed as a tonsillar mass (tonsillar hyperplasia) which caused obstructive symptoms in a young male child has been reported here. The patient presented with repeated episodes of sore throat, fever and difficulty in and pain on swallowing, of 6 months duration, along with a recent episode of high grade fever, which subsided with antibiotics.
On local examination, it was observed that there was bilateral hypertrophy of the tonsils with congested pillars and that the right tonsil appeared to be more enlarged in size than theleft one. The right side anterior pillar could not be separately differentiated from the tonsil. The tonsilolingual sulcus on the right side was obliterated and it was assumed that the palatine tonsil was enlarged and intermingled with the lingual tonsil. Bilateral tonsillectomy was perfomed and the tissue was sent for histopathological examination. The right sided mass turned out to be Neurilemmoma.
This case was worth reporting as it highlighted the importance of including schwanomma as an important differential diagnosis whenever a treating physician encountered a tonsillar mass or a mass of unexplained aetiology in the oral cavity, which caused a diagnostic dilemma. A detailed clinical history, physical examination, cytology and radiological assessment helps in differentiating schwanomma in such settings.