A Rare Case of Cervical Vagal Nerve Schwannoma in a 30-Year-Old Ethiopian Man

Abstract

Schwannoma is a slowly growing benign tumor that arises from Schwann cells. Schwannomas affect both genders equally. It occurs in any age group, but most cases are seen between the third and fifth decade. About one-fourth to one-third of extracranial schwannomas cases originate in the head and neck region. The vagus nerve, followed by the cervical sympathetic chain, is the leading site of origin in the neck region. The majority of patients with schwannomas are asymptomatic. Patients with vagal nerve schwannomas in the neck primarily present with hoarseness of voice due to paralysis of the vocal cords. Because of their rarity and the lack of a neurologic deficit as a presenting symptom, preoperative consideration of schwannomas is tough, and several differential diagnoses may be entertained.The mainstay of treatment for vagal nerve schwannoma is complete surgical excision. Here we present a rare case of cervical vagal nerve schwannoma in a 30-year-old male farmer from Ethiopia. The patient presented with a gradually increasing neck swelling of 10 years duration. He started to have hoarseness in his voice five months prior to his presentation. On examination, he had a huge anterior neck swelling. He had two FNAC results, which were inconclusive, and a neck CT. With the consideration of multinodular goiter versus spindle cell neoplasm, the neck was explored, and complete excision of the mass was done. The excisional biopsy turned out to be a classical cervical schwannoma. So this report aims to make physicians aware of the rare case of schwannomas, particularly vagal nerve schwannomas. Clinicians should consider schwannomas in the differential diagnosis of a patient presenting with a cervical mass. Furthermore, they need to be well aware of the diagnostic workup, mainly the imaging modalities, which are essential for proper preoperative planning, surgical treatment, and postoperative complications of cervical schwannomas.

Keywords:

• schwannoma
• neurilemmoma
• vagal nerve schwannoma
• neck mass
• cervical mass

Data Sharing Statement

The data used to support the findings of this study will be available from the corresponding author upon reasonable request.

Ethical Review

After obtaining permission from the Hawassa University Institutional Review Board, written informed consent was obtained from the patient for the publication of this case report, which includes images of the patient.

Acknowledgments

Dr. Endashaw Taye, a pathologist in the Department of Pathology at Hawassa University Comprehensive Specialized Hospital, did an excellent job preparing the pathologic slides, for which the author would like to express sincere gratitude. In addition, I would like to thank our patient for permitting us to write this case report.

Disclosure

The author declares no conflicts of interest for this work.