CERVICAL VAGUS NERVE SCHWANNOMA IN AN ADULT PATIENT: A CASE REPORT

Abstract

Introduction: Schwannomas are slow growing, benign, encapsulated nerve sheath tumors that derive from Schwann cells and are usually asymptomatic. Most common age of presentation is between 20 to 50 years of age and no difference in incidence among genders is noted. Schwannomas that frequently present in the head and neck region are extracranial schwannomas with an incidence of 25%-45%. Although benign, there is an 8-13.9% possibility of malignant change. Case presentation: A 41-year-old male patient presented with a history of a neck mass in the right lateral neck region, which was present for the last 8 years. However the patient begun to experience some non-specific symptoms during the last year. The main complaints were mild hoarseness of voice, episodes of bradycardia and syncope. The patient underwent Magnetic Resonance Imaging (MRI) of the neck. The MRI demonstrated a well-circumscribed, highly-vascularized mass with dimensions 3,5 x 3,5 x 1,6 cm in the right lateral neck region. The patient underwent complete surgical removal of the lesion with dissection and preservation of the vital anatomic structures. 12 months later he remains asymptomatic with no signs of recurrence. Conclusions: Vagus nerve schwannomas are rare occurring neck masses with unusual and atypical symptoms. In the case of vagus nerve schwannomas, patients occasionally present with hoarseness and a specific pathognomonic symptom of paroxysmal cough upon cervical mass palpation. Imaging is a very helpful instrument for the diagnosis and surgical planning. Complete tumor removal is the treatment of choice, as it is associated with lower recurrence rates.