Infraorbital nerve schwannoma presenting as an upper lip mass in an adolescent boy

Schwannomas of the head and neck are uncommon tumors that arise from the nerve sheath and may afflict peripheral, autonomic, or cranial nerves. It is important to consider the possible differential diagnoses of a nasolabial lump in a child because its appropriate treatment varies widely.

The authors describe a case of a 12-year-old boy who presented with a 2.5-cm right nasolabial subcutaneous lump of 3 months in duration. Computed tomographic scan showed a homogeneously attenuated lesion.

An intraoral incision was used for complete extirpation of this tumor while preserving the infraorbital nerve and facial aesthetics in this adolescent boy. Histopathologic examination showed palisades of spindle cells and Verocay bodies characteristic of schwannomas. The patient has been followed up for 2 years with no clinical evidence of recurrence.

Only 9 cases of infraorbital nerve schwannoma have been described in literature, and the sublabial intraoral incision was attempted in only 1 case. The authors describe a rare case of an extraosseous schwannoma arising from the infraorbital nerve that presented as a cheek lump, its workup, its differentials, its treatment, and a review of literature. The use of a preoperative computed tomographic scan permitted the use of a sublabial intraoral incision with good visual access to the lesion and facilitated its complete extirpation without incurring external scars.