Cervical Sympathetic Chain Schwannoma Research Articles

Synchronous cervical sympathetic chain schwannoma, parathyroid adenoma and hypofunctional nodular goiter - a case report and literature review

Synchronous cervical sympathetic chain schwannoma, parathyroid adenoma and hypofunctional nodular goiter - a case report and literature review

A Report on a Case and Literature Review on Cervical Sympathetic Chain Schwannoma that Mimics a Paraganglioma

Background: Cervical sympatric schwannoma is a rare benign tumor originating from de Schwan cells. Its clinical presentation is misleading and it can remain asymptomatic for a long time. Mostly, it appears as slow slow-growing cervical mass and may be a differential diagnosis with other neck masses such as paragangliomas. We discuss a case of Cervical sympatric schwannoma and go over its radiological, surgical, and surgical characteristics. Case Presentation: With no prior medical history, a 61-year-old lady appeared with a right cervical mass that had been present for over two years but had lately grown in size without causing dysphagia, dysphonia, or dyspnea. Clinical examination found a firm, slightly pulsatile, non-painful latero-cervical mass measuring 2 × 3 cm. Without other abnormalities on examination of the upper aerodigestive tract or thyroid gland and no neurological deficit. Cervical Ultrasound showed an oval tissular mass with regular contours in close contact with the right common carotid artery. Computed Tomography showed a right superior jugulocarotid mass located behind the vascular axis of the neck with early central vascularization. On magnetic resonance imaging (MRI), this mass was well limited, hypointense on T1 and hyper-intense on T2 with intense contrast enhancement, corresponding to a paraganglioma or schwannoma. A full blood work came back negative. Our patient underwent a complete surgical excision of the tumour which originated in the deep branches of the cervical plexus. Following surgery, the patient had Horner’s syndrome, histopathology confirmed the diagnosis of schwannoma. Conclusions: It is still challenging to differentiate between cervical sympathetic chain schwannoma and paraganglioma clinically and radiological. In the case of the schwannoma surgical approaches must be as conservative as possible to avoid damages of the origin nerve and the patient must be aware of the possibility of Horner syndrome.

ANCIENT SCHWANNOMA MASQUERADING AS CAROTID BODY TUMOR-A RARE CASE REPORT WITH REVIEW OF LITERATURE

The most common tumor at carotid artery bifurcation is a carotid body tumor causing widening of bifurcation, usually seen on conventional arteriography that can also be produced by schwannoma of the cervical sympathetic chain. Ancient schwannoma is the uncommon variety of schwannoma, a benign tumor that arises from the nerve sheath. It usually arises from any nerve except the optic and olfactory. Here we present a rare case of a male in his early 50s with lateral neck swelling diagnosed radiologically and excised as a carotid body tumor diagnosed as ancient schwannoma on histopathological examination. Although quite rare, cervical sympathetic chain schwannoma should be considered a differential diagnosis for tumors at the carotid bifurcation. Insight into morphological features of ancient schwannoma avoids misdiagnosis as a malignant nerve sheath tumor.

A rare case of schwannoma of the mandibular nerve extending to parapharyngeal space managed with a preauricular trans mandibular approach

Schwannoma also referred to as neurilemmoma or neurinomas arise from the Schwann cells of the autonomic nerves, peripheral nerves and cranial nerves except optic and olfactory nerves. Head and neck schwannomas account for 25 to 45% of schwannomas and the most common being vagal schwannomas and cervical sympathetic chain schwannomas. Schwannomas arising from the trigeminal nerve are rare and this case report consists of a schwannoma presenting as a left preauricular swelling involving the region of parotid extending from foramen ovale through the infratemporal fossa up to the parapharyngeal space. A combined preauricular trans mandibular approach enabled a complete excision of the tumor. Histopathological confirmation of a benign schwannoma was obtained and the patient is feeling well with minimal postoperative facial palsy with no trismus, occlusion abnormalities and no signs of recurrence on follow up.

Schwannoma of Cervical Sympathetic Chain

Schwannomas may occur spontaneously or in the context of a familial tumour syndrome such as neurofibromatosis type 2 (NF2), schwannomatosis and Carney's complex. Schwannoma arising from the cervical sympathetic chain is an uncommon benign nerve tumour and is a diagnostic challenge. This tumour most often presents as an asymptomatic solitary neck mass, with slow-growing and rare malignant degeneration. Definitive pre-operative diagnosis may be difficult and investigations are not usually helpful. Diagnosis relies on clinical suspicion and confirmation is often obtained using surgical pathology. Surgical excision is the treatment of choice for this tumour, with recurrence being rare. Horner’s syndrome is a common postoperative neurological consequence but does not appear to cause problems to the patient. we describe our experience with clinical presentation, surgical management, and the outcome of a patient who presented with this pathology.

Intracapsular Enucleation of Cervical Sympathetic Chain Schwannoma.

Schwannoma arising from cervical sympathetic chain (CSC) is a rare clinical entity. CSC is hard to preserve in CSC schwannoma (CSCS) surgeries, resulting in Horner's syndrome (HS) and first bite syndrome (FBS). This article aims to explore our experience in successful preservation of CSC in CSCS surgeries. This is a retrospective review of CSCS cases treated at our tertiary medical institution between Apr 2018 and March 2022. Only cases with successful intraoperative preservation of CSC were included. In total, 3 cases were included. There were 2 male patients and 1 female patient. Their age was between 38years old and 66years old (average and median age was 52 and 51 years old, respectively). Presenting symptom was neck mass for all them, 2 of which were on the left side, while 1 was on the right. Intracapsular enucleation of the CSCS was attempted and achieved in all 3 cases. Hemorrhage from the inner surface of capsules was diffuse and heavy. Constant saline irrigation, suction, and bipolar coagulation were needed to achieve hemostasis. Postoperative HS presented between 4hours and 14 hours after surgery for all 3 patients, which took 1 month to 3months to recover, whereas FBS did not occur in any patient. Median duration of follow-up was 6 months. No recurrence was observed. Intracapsular enucleation should be attempted in CSCS surgeries, although hemorrhage might be diffuse and hard to control. When intracapsular enucleation was achieved, postoperative FBS can be avoided, while postoperative HS could occur, but its recovery was satisfactory.

Cervical sympathetic chain schwannoma: a case report

Neurogenic tumors including Schwannoma are the rare cause of the lateral neck swelling. We present a case of cervical sympathetic plexus schwannoma that was successfully managed by surgical excision. A 30-year-old male presented with complaints of painless slow growing swelling on the right side of neck of 6 months duration. On examination a single, non-tender, pulsatile swelling of 4×3 cm in the right lateral side of neck was seen beneath the anterior margin of the sternocleidomastoid and just below the angle of the mandible. Magnetic Resonance Imaging (MRI) neck showed a well-defined lesion of size 4.5×4.6×6 cm in the right carotid space with features suggestive of neurogenic tumour arising from sympathetic plexus, likely Schwannoma. Surgical excision of the tumour was done. Intra-operatively a well encapsulated lesion was present in the right carotid sheath arising likely from right cervical sympathetic plexus. Histopathological examination confirmed the diagnosis of Schwannoma. Post-operatively patient developed mild ptosis of right eye; however at 6 months follow-up patient is doing fine without any evidence of residual neurological loss or recurrence.

Anaesthetic management of a patient for cervical sympathetic chain schwannoma excision.

Anaesthetic management of a patient for cervical sympathetic chain schwannoma excision.

A Study on Surgical Results of Cervical Sympathetic Chain Schwannoma

A Study on Surgical Results of Cervical Sympathetic Chain Schwannoma

Facial pain: a rare presenting symptom of sympathetic chain schwannoma

<p>Schwannoma is a nerve sheath tumour that usually presents as an asymptomatic lump. We report a case where facial pain was the only symptom of the tumour. Surgical excision was done. Intraoperative findings and Horner syndrome confirmed the diagnosis of cervical sympathetic chain schwannoma. Histopathology was also consistent with the diagnosis. The patient did well postoperatively.</p>

Cervical Sympathetic Chain Schwannoma-Our Experience.

Tumours arising from the parapharyngeal space are uncommon. The most common tumour arising primarily from this region is a neurogenic tumour, especially Schwannoma. The most common site of origin of a Schwannoma in parapharyngeal space is Vagus nerve. Cervical sympathetic chain (CSC) schwannomas are extremely rare. Here, we discuss a case of a 30-year old female with cervical sympathetic chain schwannoma, the clinical presentation, diagnosis and management.

Horner’s syndrome caused by the cervical sympathetic chain schwannoma

Horner’s syndrome caused by the cervical sympathetic chain schwannoma

A Case of Malignant Sympathetic Paraganglioma Presenting with Horner Syndrome

A 51-year-old male was referred to us with a tumor in the left neck that had been found incidentally on MRI of the cervical spine. Physical examination revealed Horner syndrome on the left side. We considered the possible diagnosis of cervical sympathetic chain schwannoma; however, fine needle aspiration and PET-CT findings led to the suspicion of malignancy. We resected the tumor under general anesthesia. After the operation, the patient developed transient left vagus nerve palsy. Histopathology revealed the diagnosis of malignant paraganglioma with lymph node metastasis.

Cervical root schwannoma: a case series

Cervical root schwannoma is an infrequent benign peripheral nerve tumor though those arising from high cervical spinal root are common amongst the spinal schwannomas. This mass commonly presents as a slow growing, asymptomatic, solitary neck mass with rare potential of malignant degeneration. Displacement of Internal jugular vein and carotids anteriorly is frequently seen though abutment of esophagus is uncommon. Pre operative diagnosis can be established with imaging and Fine needle aspiration cytology (FNAC). Complete Surgical excision is the treatment of choice. Horner’s syndrome is the most common post operative neurological manifestation. Here we have recorded clinical features intra-operative findings and surgical histopathology. We have described a case of 19 year old male with cellular schwannoma of cervical sympathetic chain with intraspinal extension and arising from C5-C8 level. Another case of cervical root schwannoma is described in a 5 year old girl arising at C4-C5 level. Complete surgical excision was done for both patients with no postoperative neurological affection. The clinico-pathological evaluation and management are described

Cervical sympathetic chain schwannoma presenting as a carotid body tumor

Nerve sheath tumours arising from the sympathetic chain are extremely rare and are a diagnostic challenge. Schwannomas are benign nerve sheath tumours deriving from Schwann cells that occur in the head and neck region in 25-45% of cases. Cervical lesions originate from spinal nerves, the last four cranial nerve roots, or occasionally from the sympathetic chain. Carotid body tumour (CBT), the most common tumour of the carotid bifurcation, presents as a pulsatile mass. Cervical sympathetic chain (CSC) schwannomas are slow growing lesions and may appear pulsatile due to the displacement of vascular structures by the non-vascular mass and thus may mimic a CBT. We here in discuss a case of 22year old female, who underwent surgical resection of a mass at carotid bifurcation, presuming a CBT, but postoperative histopathological examination revealed it a schwannoma.

Cervical sympathetic chain schwannoma associated with parathyroid adenoma

Abstract Background Schwannoma is a rare benign tumour derived from nerve sheaths. When derived from the cervical sympathetic chain, it usually presents itself as an asymptomatic mass located in the posterior cervical region, at paravertebral level. Its diagnosis is not easy, usually requiring multiple imaging tests. Its differential diagnosis includes parathyroid adenoma. Clinical case A new case of schwannoma of the cervical sympathetic chain in a patient with a synchronous overactive parathyroid adenoma is reported. This case adds to the 60 described in the literature, although to our knowledge no association between schwannoma and parathyroid adenoma has been reported to date. Conclusions Despite being a benign tumour, its treatment is a complete surgical resection. The most common complication after the surgery needed for these tumours is ipsilateral Horner syndrome.

Cystic schwannoma of cervical sympathetic chain masquerading as type II second branchial cleft cyst

<p class="abstract"><span lang="EN-US">Brachial cleft cyst is the most common differential diagnosis of benign lateral neck swelling but other cystic swellings like carotid body tumours and cystic schwannomas should be kept in mind. MRI of neck is of great assistance in determining the nature of the swelling as fine needle aspiration cytology will fail in diagnosing such swellings accurately. We present a case of 22 year old female who presented with a slow growing swelling which was diagnosed as brachial cyst on FNAC and CT but turned out to be cystic schwannoma of cervical sympathetic chain which highlights the importance of considering various differentials of lateral neck swelling and limitation of FNAC and importance of pre-operative MRI in such cases.</span></p>

Four Cases of Cervical Sympathetic Chain Schwannoma and Review of Literature

ABSTRACT Schwannomas are benign, solitary and well-differentiated tumors originating from schwann cells. They may originate from any of the peripheral, cranial or autonomic nerves of the body with the exception of the olfactory and the optic nerves. This tumor most often presents as a slow growing asymptomatic solitary neck mass which rarely undergoes malignant transformation. Schwannomas arising from the cervicalsympathetic chain are very rare. Only < 65 cases have been reported in the literature to date. Computed tomography with contrast medium or magnetic resonance imaging is essential to the initial workup for cervical sympathetic chain schwannoma (CSCS). Surgical excision is the treatment of choice for this tumor. Only surgical observation of the lesion and the nerve from where it originates, and histologic examination of the specimen, can lead to a correct diagnosis. We report four cases of cervical sympathetic chain schwannomas presented in our department during last two and half years which were treated by surgical excision. How to cite this article Divya GM, Ramachandran K, Nampoothiri PM, Sunil Kumar KP. Four Cases of Cervical Sympathetic Chain Schwannoma and Review of Literature. Int J Head Neck Surg 2015;6(2):86-89.

Diagnostic approach, treatment, and outcomes of cervical sympathetic chain schwannomas: a global narrative review.

This review examined the diagnostic approach, surgical treatment, and outcomes of cervical sympathetic chain schwannomas (CSCS) to guide clinical decision making. Medline, EMBASE, and Cochrane databases. A literature review from 1998 to 2013 identified 156 articles of which 51 representing 89 CSCS cases were evaluated in detail. Demographic, clinical, and outcomes data were extracted by 2 independent reviewers with high interrater reliability (κ = .79). Cases were mostly international (82%), predominantly from Asia (50%) and Europe (27%). On average, patients were 42.6 years old (SD = 13.3) and had a neck mass ranging between 2 to 4 cm (52.7%) or >4 cm (43.2%). Nearly 70% of cases were asymptomatic at presentation. Presurgical diagnosis relied on CT (63.4%), MRI (59.8%), or both (19.5%), supplemented by cytology (33.7%), which was nearly always inconclusive (96.7%). US-treated cases were significantly more likely to receive presurgical MRI than internationally treated cases but less likely to have cytology (P < .05). Presurgical diagnosis was challenging, with only 11% confirmatory accuracy postsurgically. Irrespective of mass size, extracapsular resection (ie, complete resection with nerve sacrifice) was the most frequently (87.6%) performed surgical procedure. Common postsurgical adverse events included Horner's syndrome (91.1%), first bite syndrome (21.1%), or both (15.7%), with higher prevalence when mass size was >4 cm. Adverse events persisted in 82.3% of cases at an average 30.0 months (SD = 30.1) follow-up time. Given the typical CSCS patient is young and asymptomatic and the likelihood of persistent morbidity is high with standard surgical approaches, less invasive treatment options warrant consideration.

Cervical Sympathetic Chain Schwannomas: A Global Systematic Review Provides Insight on Diagnosis, Treatment, and Outcomes

Objectives: Systematically evaluate the diagnosis, treatment, and outcomes of globally published cases of cervical sympathetic chain schwannomas (CSCS) to guide clinical decision making. Methods: Using Medline, EMBASE, and Cochrane databases, 89 CSCS case reports/series were identified from 1997 to 2013. Most cases were treated internationally (82%), predominantly in Asia (50%) and Europe (27%). Demographic, clinical, and outcomes data were extracted by 2 independent reviewers with high interrater reliability (k = 0.79). P &lt; .05 denoted statistical significance. Results: On average, patients were 42.6 years old (SD = 13.3) and had a 2 to 4-cm (52.7%) or &gt;4-cm (43.2%) neck mass. Nearly 70% of cases were asymptomatic. Presurgical diagnosis relied heavily on computed tomography (63.4%), magnetic resonance imaging (MRI; 59.8%), or both (20%), supplemented by cytology (47.6%). US-treated cases were significantly more likely to receive pre-surgical MRI than internationally treated cases, but less likely to have cytology or histopathology ( P &lt; .05). Presurgical diagnosis accuracy was only 11% as confirmed postsurgically. Extracapsular (complete) resection was more commonly performed than intracapsular resection (87.6%), irrespective of mass size and treatment country. Postsurgical adverse events (AEs) were more common with the extracapsular approach and when mass size was &gt;4 cm. Reported AEs included Horner’s syndrome (89.9%), First Bite syndrome (21.1%), or both (15.7%). AEs persisted in 81.1% of cases, with 28.8 months (SD = 27.1) average follow-up time. Conclusions: Given the typical CSCS patient is young and asymptomatic, presurgical diagnostic accuracy is very low, and the likelihood of persistent postsurgical morbidity is high with aggressive extracapsular surgery, less invasive approaches to differentially manage CSCS are warranted.