Norhafiza Mat Lazim*
Department of Otorhinolaryngology-Head & Neck Surgery, Universiti Sains Malaysia, MalaysiaFulltext PDF
Background: Paraganglioma of head and neck is a rare tumor and vagal schwannoma is even rarer. The majority of patient with vagal schwannoma presents with lateral cervical neck mass. Typically, it is a slow growing, painless and mobile tumor but it has high tendency to become malignant compare to other subtypes of paraganglioma. The choice of treatment includes surgery, radiation or observation and it depends on the characteristic of tumor as well as patient’s preference.
Case Description: A 22-year old lady presented with history of a right neck mass for 5-months duration. Clinical examination revealed a mass at level II neck region which measures 3.0 cm × 2.0 cm and it was mobile, non-pulsatile and had smooth surface. CT scan and angiogram showed that the mass arises between carotid artery and vagal nerve and it was a highly vascular lesion. A CT scan-guided biopsy performed but complicated with neck hematoma and patient developed hoarseness. On follow up, her hoarseness persists and her tissue biopsy came back as schwannoma. She was counselled regarding surgery versus radiation for her treatment and she agreeable for surgery. Hence, surgical excision was performed and intraoperatively it showed that the mass arose from the vagal nerve.
Conclusion: Vagal schwannoma is a rare paraganglioma of head and neck. Patient’s symptom as in this case, the complaint of hoarseness can give clue to the origin of the lesion and meticulous extirpation of the mass should be practiced in order to avoid inadvertent injury to intimate important neurovascular structures.
Vagal nerve; Schwannomas; Paraganglioma; Head and neck; Excision
Lazim NM. Surgical Resection of Vagal Schwannoma in a Young Female. Clin Case Rep Int. 2018; 2: 1077.