Cervical sympathetic chain schwannoma: a case report

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.