Intraparotid Facial Nerve Schwannoma - A Case Report

Abstract

Abstract Rationale: Intraparotid facial nerve schwannoma (IPFNS) is a rare entity. Diagnosing these tumours is challenging as multiple differential diagnoses exist for swellings in the infraauricular region. Delay in diagnosis can lead to adverse outcomes. Patient Concerns: A 27-year-old female presented with swelling over the left infraauricular region, which concerned her cosmetic appearance. Diagnosis: It was initially misdiagnosed with imaging techniques computerised tomography (CT scan) and fine-needle aspiration cytology, leading to a diagnostic dilemma. Treatment: Superficial parotidectomy was planned and intraoperatively, a cystic lesion was seen adherent to the temporal branch of the facial nerve, which was resected along with the nerve branch. Histopathology confirmed the diagnosis as facial nerve schwannoma. Outcomes: The patient’s cosmetic concern was resolved but there was loss of wrinkles over the ipsilateral forehead region. No recurrence was seen. Take-Away Lessons: IPFNS often causes a diagnostic dilemma and an appropriate and timely diagnosis is required to decrease the morbidity and undertreatment.