DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201304

Parapharyngeal schwannomma: a case report

Manjunath K., Amardeep Singh, Smitha V.

Abstract


Schwannomas are uncommon neurogenic tumors that are typically benign, slow growing, and asymptomatic. Upto 45% of schwannomas arise from the head and neck region, the sites of origin are: face, scalp, intracranial cavity, orbit, nasal and oral cavities, parapharyngeal space, middle ear, mastoid, larynx, and medial and lateral regions of the neck.  The age distribution is 30 to 70 years and male:female 3:1. Symptoms and signs are neck swelling (54%), pain (11%), cranial nerve palsy (10%), oropharyngeal swelling (8%), dysphagia (6%) and trismus, otalgia (11%). This case is being presented because it is the rare case of neck swelling.  A young male patient aged 22 yrs, presented with complains of swelling in right side of neck since 6 months. Patient also complains of difficulty in swallowing, difficulty in breathing and change in voice since 4 months. On examination of neck, a diffuse swelling noted at right level III neck, extending from the superior border of thyroid cartilage up to the level of hyoid bone.  Horizontally the swelling was extending from mid thyroid cartilage till the anterior border of sternocleidomastoid muscle. On examination of swelling, a pink smooth globular mass seen pushing the right aryepiglottic fold anteriorly obscuring the laryngeal inlet. No pooling of saliva. elective tracheostomy was done, through lateral cervical approach, mass was excised in toto and extubated after 7 days.


Keywords


Schwannoma, Neurilemmoma, Parapharyngeal tumour

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References


Cavallaro G, Pattaro G, Iorio O, Avallone M, Silecchia G. A literature review on surgery for cervical vagal schwannomas. World J Surg Oncol. 2015;13:130.

Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: Diagnostic overview and update on selected diagnostic problems. Acta Neuropathol, 2012;123(3):295-319.

Sreevatsa MR, Srinivasarao RV. Three cases of vagal nerve schwannoma and review of literature. Indian J Otolaryngol Head Neck Surg, 2011;63(4):310-2.

Chiofalo MG, Longo F, Marone U, Franco R, Petrillo A, Pezzullo L. Cervical vagal schwannoma. A case report. Acta Otorhinolaryngol Ital. 2009;29(1):33-5.

Chang SC, Schi YM. Neurilemmoma of the vagus nerve:a case report and brief literature review. Laryngoscope. 1984;94:946-9.

Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, Brennan P, O’Dwyer AJ, et al. Head and neck schwannomas—a 10-year review. J Laryngol Otol. 2000;114:119-24.

Ford LC, Cruz RM, Rumore GJ, Klein J. Cervical cystic schwannoma of the vagus nerve:diagnostic and surgical challenge. J Otolaryngol. 2003;32:61-3.

Fujino K, Shinohara K, Aoki M, Hashimoto K, Omori K. Intracapsular enucleation of vagus nerve-originated tumours for preservation of neural function. Otolaryngol Head Neck Surg. 2000;123:334-6.

Gilmer-Hill HS, Kline DG. Neurogenic tumours of the cervical vagus nerve:report of four cases and review of the literature. Neurosurgery. 2000;46:1498-503.

Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24:1477-81.