Vagal nerve Schwannoma- An interesting case presenting as lateral neck swelling

Abstract

A Schwannoma is a benign nerve sheath tumor composed of Schwann cells. Schwannoma arising from the vagus nerve is an uncommon (2–5%) benign nerve tumor. Less than 1% becomes malignant. Definitive pre-operative diagnosis may be difficult and investigations such as FNAC have low specificity. Surgical removal of tumor is the treatment of choice for vagal schwannomas with nerve preservation. Surgical removal can be done either by intra capsular enucleation or extra capsular excision of tumor. Definitive diagnosis is obtained by means of surgical pathology. Here we present a case of 40 year old male presented with swelling over anterio -lateral aspect of left lower neck region for last four years with mild change in his voice for few months. CECT of the neck was suggestive of left neck cystic necrotic lesion. On FNAC the swelling was misdiagnosed as colloid nodule. The mass was excised. Grossly a single encapsulated globular cystic tissue piece measuring 8.5x7x6 cm was received in histopathology lab, which on cut section show a unilocular cyst filled with blood mixed mucoid material. On Histopathology, a diagnosis of Schwannoma was rendered. Keywords: Benign tumor, Neck swelling, Schwannoma, Vagal nerve.