Simultaneous occurrence of two different neck tumors

Introduction The preoperative differential diagnosis of tumor in the Head and Neck are in particular cases challenging for surgeons and radiologists. In many cases, the diagnosis can only be performed during surgery and confirmed with a histopathology exam.

Case report We describe an unusual case of a 35 years old female with no previous diagnosis who presented with a 2 x 3 cm painless mass on the right side of the neck. Differential diagnoses included hemangioma, and glomus tumor. The initial MRI-report described two hemangiomas. The follow up was conducted with contrast MRI and sonography of the neck with no progression in size. A surgical resection was planned to lower the risk of possible complications arising from the localization of the masses. Surgical exploration showed that one mass appeared to come from a blood vessel while the second mass was adherent to the vagus nerve. Successful excision of the two masses was completed. The histopathology showed a cavernous hemangioma and a vagal schwannoma. Postoperative, the patient showed no complications.

Conclusion Despite clinical exams and imaging, diagnostic histopathological samples should be obtained during surgery to ensure the final diagnosis. Therefore is recommended in simultaneous occurrence of tumors the preoperative risk assessment about the possible complications of the surgery and an individual surgical plan. Simultaneous occurrence of hemangioma and schwannoma in the head and neck are rare occurence.

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Publication History

Article published online:
10 June 2020