Giant Ancient Schwannoma of the Lateral Neck Presenting with Preoperative Horner's Syndrome

Abstract

Schwannoma is a benign neoplasm of nerve sheath origin except olfactory and optic nerves. The incidence of the head and neck lesion is 20-45%, and it may also arise in the vagus, hypoglossal, lingual, cervical sympathetic chain and brachial plexus in the order of frequency. In earlier reports, five variants of schwannomas have been described; common, plexiform, cellular, epithelioid, and ancient type. The ancient schwannoma (AS) is characterized with degenerative changes, hyperchromatism and marked nuclear atypia, which differentiates itself from the typical type. In cervical sympathetic chain schwannoma (CSCS), the most common post-operative complication is the Horner’s syndrome. However, preoperative Horner’s syndrome in CSCS is extremely rare. The following is a clinical report about a giant AS from cervical sympathetic chain (CSC), accompanied with preoperative Horner’s syndrome. To the best of our knowledge, such case has not been reported earlier.