The original nerve of a greater occipital nerve schwannoma causing occipital neuralgia identified with magnetic resonance neurography

Abstract

Schwannomas are benign tumors arising from Schwann cells in the peripheral nerve and rarely develop at suboccipital area. We report a case of a greater occipital nerve schwannoma causing occipital neuralgia. The original nerve of the schwannoma was identified with Magnetic Resonance (MR) neurography. A sixty-something male patient was admitted for a suboccipital mass. Physical examination revealed an about 4 cm beaded masses subcutaneously at suboccipital area. MR imaging showed that the lesions were not suppressed on 3 dimensional T2 weighting with fat suppression. Three dimensional fusion images (3 dimensional T2 weighting with fat suppression and 3-dimensional computed tomography) clearly revealed the original nerve of the lesions. The patient underwent a complete excision on the tumor. Histopathological examination diagnosed it as a schwannoma. The MR neurography findings contributed to preoperatively diagnose the tumors as a greater occipital nerve schwannoma.