Extracranial schwannoma located in the cervical plexus – a very rare manifestation of schwannomas

Introduction:

Schwannomas are benign, slow growing encapsulated perineurial tumors, originating from Schwann cells of peripheral nerves. They are very rare and usually solitary. Almost 25% are located in the head and neck region. Sympathetic trunk and vagus nerve followed by the facial nerve are the most common nerves of origin.

Case report:

We present a case of a 39 year old man with an asymptomatic, slowly enlarging, solitary palpable neck mass on the left side. MRI showed a well defined, heterogeneously hyperintense (T2-weighted) lesion in the left cervical space measuring 1.9 × 1.5 × 1.2 cm.

The well subscribed mass was totally excised via a left transcervical approach. The mass was located medial the great vessels near to the intervertebral foramen. A single branch of the cervical plexus was identified as the nerve of origin.

The histological examination confirmed a schwannoma with Antoni A and B cells. At the 3 month postoperative visit there was no recurrence or neurological deficit noted.

Conclusion:

Schwannomas in the head and neck region are rare und usually solitary lesions. In this context von Recklinghausen's disease should be considered. MRI is the investigation of choice in the diagnosis of schwannomas and the identification of the nerv of origin. In literature the cervical plexus is a very rare nerve of origin. At present, complete surgical resection with preservation of the neural pathway is the accepted treatment.

Dr. med. Benedikt Knof

Klinikum Lüdenscheid,

Paulmannshöher Str. 14, 59515

Lüdenscheid

Email: [e-mail]

Publication History

Publication Date:
23 April 2019 (online)