Abstract

Aim:To report an highly unusual case of Ancient schwannoma (AS) in the temporal scalp region and to emphasize the importance of histopathological evaluation in diagnosing scalp lesions that mimic more common entities. Materials and methods: An young adult male (24 years old) reported with a slowgrowing non-tender scalp lesion of two years’ duration in the left temporal region. Clinical examination and ultrasonography suggested a benign subcutaneous lesion, initially suspected to be a lipoma. The scalp mass was surgically excised in its entirety under local anaesthesia and sent for histopathological analysis. A systematic review of literature from PubMed and Google Scholar was also conducted to identify similar cases. Results and conclusion: The diagnosis of ancient schwannoma was established histologically, based on encapsulated spindle cell morphology, presence of Antoni A and B areas, Verocay body formation and degenerative changes including hemorrhage and hemosiderin deposition. The patient had an uncomplicated postoperative course, and follow-up at one year revealed no signs of recurrence. Only three prior cases of AS of the scalp were found in the literature, underscoring its rarity. This case reinforces the necessity of considering AS in the differential diagnosis of atypical scalp lesions and highlights that histopathology remains the gold standard for diagnosis. Surgical excision remains the definitive and curative treatment, with excellent outcomes and minimal recurrence.

Keywords

scalp tumor, temporal region, schwannoma, verocay bodies, surgical excision