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LETTER TO EDITOR Table of Contents   
Year : 2010  |  Volume : 53  |  Issue : 4  |  Page : 873-874
Neurilemmoma (Schwannoma) of the thyroid gland: A rare case presentation


1 Department of Pathology, L.L.R.M. Medical College, Meerut, India
2 Department of Pathology, Muzaffarnagar Medical College, Muzaffarnagar, India

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Date of Web Publication27-Oct-2010
 

How to cite this article:
Mangal N, Agarwal AK, Sharma VK, Sharma SP. Neurilemmoma (Schwannoma) of the thyroid gland: A rare case presentation. Indian J Pathol Microbiol 2010;53:873-4

How to cite this URL:
Mangal N, Agarwal AK, Sharma VK, Sharma SP. Neurilemmoma (Schwannoma) of the thyroid gland: A rare case presentation. Indian J Pathol Microbiol [serial online] 2010 [cited 2019 Dec 14];53:873-4. Available from: http://www.ijpmonline.org/text.asp?2010/53/4/873/72023


Sir,

Primary peripheral nerve sheath tumors commonly arise in the soft tissues of the neck and may secondarily involve the thyroid gland. [1] Primary neural tumors of the thyroid are exceedingly rare and are mainly represented by Schwannomas and malignant peripheral nerve sheath tumors. [2],[3] A review of the literature revealed only 15 cases of intra-thyroidal Schwannomas so far, mostly reported as single case reports. We report yet another case of an intra-thyroidal Schwannoma in a 25-year-old woman presenting as a palpable thyroid nodule.

A 25-year-old woman presented with an asymptomatic, gradually increasing, nodule for 4 months in the right lobe of the thyroid gland. Physical examination revealed an oval, firm, non-tender, 2 cm nodule in the right side of the lower neck region, which was moving with deglutition. There was no cervical lymphadenopathy. Hormonal studies showed normal serum levels of TSH, FT4 and FT3. The patient underwent hemi-thyroidectomy with a provisional diagnosis of nodular goitre. Grossly, the excised thyroid tissue measured 4 cm x 3 cm x 3 cm and contained a 2 cm well-encapsulated, solid, gray-white surface, firm nodular mass. The well-encapsulated neoplastic tissue consisted of mixed patterns of Antoni A and Antoni B [Figure 1] with a predominant pattern A having Verocay bodies. The thyroid tissue was seen compressed at one side at the periphery of the tumor area. Also, few thyroid follicles lined by benign follicular epithelial cells and filled with colloid were seen interspersed within the tumor area [Figure 1]. Based on the morphologic features, a primary neurilemmoma of the thyroid gland was diagnosed.
Figure 1: Neurilemmoma thyroid showing Antoni A pattern along with colloid-filled follicles (H and E, ×40)

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Primary Schwannomas arising within the thyroid gland are extremely rare. Their origin from the intra-thyroidal sensory nerves or sympathetic and parasympathetic innervation has been postulated. [3] To the best of our information till date, only 15 cases of primary Schwannoma of the thyroid gland have been documented in the English literature, including one case of "ancient Schwannoma." [4] Such cases have been reported at all ages, but are most common in middle-aged females. Clinically, pre-operative diagnosis of thyroid Schwannomas by Fine Needle Aspiration C ytology has been successfully made in some of the cases. [1] However, histopathological examination confirms the diagnosis. This case is presented because of its rare occurrence in the thyroid.

 
   References Top

1.Aron M, Kapila K, Verma K. Neural tumours of the neck presenting as thyroid nodules: A report of three cases. Cytopathology 2005;16:206-9.  Back to cited text no. 1
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2.Badwai RA, Scott-Coombes D. Ancient schwannoma masquerading as a thyroid mass. Eur J Surg Oncol 2002;28:88-90.  Back to cited text no. 2
    
3.Thompson LD, Wenig BM, Adair CF, Heffess CS. Peripheral nerve sheath tumors of the thyroid gland: A series of four cases and a review of the literature. Endocr Pathol 1996;7:309-18.  Back to cited text no. 3
[PUBMED]    
4.Magro G, Torrisi A, Amico P, Presti C, Ippolito G, Ippolito O. Ancient schwannoma of the thyroid: Report of a case and comprehensive review of the literature. Am J Case Rep 2008;9:182-7.  Back to cited text no. 4
    

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Correspondence Address:
Nidhi Mangal
H. No.-285, Lane No. 19, Gandhi Colony, Muzaffarnagar, Uttar Pradesh - 251 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.72023

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