CLINIAL CASES 

Otorinolaringologia 2005 September;55(3):221-5

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Schwannoma of the cervical sympathetic chain. Case report

Isik A. C. U. ¹, Reis A. K. ², Kosucu P. ³

¹ Department of Otolaryngology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey 2 Department of Pathology Karadeniz, Technical University Faculty of Medicine, Trabzon, Turkey 3 Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey

Schwannomas of the head and neck are unusual neurogenic tumors that occur from any autonomic, peripheral or cranial nerve. Twenty-five to 45 percent of extracranial schwannomas arise in head and neck region. We describe a patient with a cervical sympathetic chain schwannoma. The patient was a 23-year-old woman with a 10-month history of a painless, enlarging right neck mass. Results of head and neck examination were otherwise within normal limits. The patients underwent neck exploration and resection of the mass. During the operation a well encapsulated tumor was found to be growing from the cervical sympathetic chain posterior to the carotid bifurcation. A total resection was performed and a section of the cervical sympathetic chain was sacrificed. Postoperatively, head and neck examination revealed no vagal and hypoglossal nerve dysfunction but a horner’s syndrome was present. Histopathology confirmed tumor to be schwannoma of the cervical sympathetic chain. The patient was free of disease at clinically and CT evaluation 4 year after surgery. Surgical excision remains the treatment of choice, often requiring sacrifice of a portion of the sympathetic chain Tumor excision gives excellent results with no local recurrence. We discuss the differential diagnosis, evaluation, surgical management, and pathological characteristics of the schwannomas of the cervical sympathetic chain and review the literature.