DOI: http://dx.doi.org/10.18203/2349-2902.isj20221728

Cervical sympathetic chain schwannoma: a case report

Anil Choudhary, Shadan Ali, Anup Mohta, Ashok Kumar, Lalit Aggarwal, Jenna B. Bhattacharya, M. Sai Sri Harsha

Abstract


Neurogenic tumors including Schwannoma are the rare cause of the lateral neck swelling. We present a case of cervical sympathetic plexus schwannoma that was successfully managed by surgical excision. A 30-year-old male presented with complaints of painless slow growing swelling on the right side of neck of 6 months duration. On examination a single, non-tender, pulsatile swelling of 4×3 cm in the right lateral side of neck was seen beneath the anterior margin of the sternocleidomastoid and just below the angle of the mandible. Magnetic Resonance Imaging (MRI) neck showed a well-defined lesion of size 4.5×4.6×6 cm in the right carotid space with features suggestive of neurogenic tumour arising from sympathetic plexus, likely Schwannoma. Surgical excision of the tumour was done. Intra-operatively a well encapsulated lesion was present in the right carotid sheath arising likely from right cervical sympathetic plexus. Histopathological examination confirmed the diagnosis of Schwannoma. Post-operatively patient developed mild ptosis of right eye; however at 6 months follow-up patient is doing fine without any evidence of residual neurological loss or recurrence.


Keywords


Schwannoma, Neurilemmomas, Sympathetic chain, Neck tumors

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References


Som PM, Biller HF, Lawson W. Tumors of the parapharyngeal space: preoperative evaluation, diagnosis and surgical approaches. Ann Otol Rhinol Laryngol Suppl. 1981;90(1 Pt 4):3-15.

Putney FJ, Moran JJ, Thomas GK. Neurogenic tumors of the head and neck. Laryngoscope. 1964;74:1037-59.

Liu HL, Yu SY, Li GK, Wei WI. Extracranial head and neck Schwannomas: a study of the nerve of origin. Eur Arch Otorhinolaryngol. 2011;268:1343-7.

Navaie M, Sharghi LH, Cho-Reyes S, Keefe MA, Howie BA, Setzen G. Diagnostic approach, treatment, and outcomes of cervical sympathetic chain schwannomas: a global narrative review. Otolaryngol Head Neck Surg. 2014;151:899-908.

Aydin S, Sanli A, Tasdemir O, Gul A E. Horner's syndrome postexcision of a huge cervical sympathetic chain schwannoma. Turk J Med Sci. 2007;37:185-90.

Som PM, Sacher M, Stollman AL, Biller HF, Lawson W. Common tumors of the parapharyngeal space: refined imaging diagnosis. Radiology. 1988;169:81-5.

Yu GH, Sack MJ, Baloch Z, Gupta PK. Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma. Cytopathology. 1999;10:186-94.

Al-Ghotani B, Abo-Shdeed B, Alassaf A. Schwannoma of the sympathetic trunk: A case report. Ann Med Surg (Lond). 2021;68:102624.

Netterville JL, Groom K. Function-sparing intracapsular enucleation of cervical schwannomas. Curr Opin Otolaryngol Head Neck Surg. 2015;23:176-9.