Cervical sympathetic chain schwannoma

Abstract

Introduction: Cervical schwannoma is a benign peripheral nerve tumor specifically developing from Schwann cells. Cervical sympathetic chain schwannoma is rare. Following a case report, the authors describe its specific radiological and histological characteristics. Treatment is surgical.

Clinical case: A 56-year-old woman consulted for an isolated left lateral cervical mass of several years' standing, but with recently associated pharyngeal discomfort. Cervical CT revealed a vascularized retrostyloid mass with venous-time enhancement, inducing anterior displacement of the jugulo-carotid axis. The tumor could not be identified on fine-needle aspiration cytology, and surgical resection was performed by cervicotomy. Surgical exploration found a tumor developing from the cervical sympathetic nerve, posterior to the jugular vein and carotid sheath. Histopathologic examination diagnosed schwannoma. Postoperative outcome featured Horner's syndrome.

Conclusion: Cervical sympathetic chain schwannoma is a rare benign tumor, to be suspected in the presence of an isolated lateral cervical mass. Preoperative CT is mandatory to guide diagnosis; treatment is surgical, to confirm histologic diagnosis. Postoperative Horner's syndrome often confirms cervical sympathetic chain involvement.