Cervical vagal schwannoma. Single case report

Abstract

Schwannomas of the cervical vagal nerve are rare neoplasms, usually occurring between the third and the sixth decade of life. They don’t demonstrate any sex predilection, and they often present as slow-growing, palpable neck masses, leftright sided, without early neurological symptoms, and they are often confused with enlarged lymphnodes or lipomas. Several differential diagnosis should be considered. Imaging techniques are largely used to define their etiology. If they are considered primary to evaluate their relationship with surrounding structures (i.e. omolateral neck vessels and nerves, oesophagus, trachea), they don’t always result decisive for a correct differential diagnosis. Surgical excision is the treatment of choice: when technically possible, nerve sparing technique has to be preferred to en-bloc resection, because of the possibility of neurological outcomes such as dysphonia, dysphagia, hoarseness, vocal cord paralysis after surgical therapy. We report our case about a 34 years-old male, evaluating differential diagnosis course, choosing the correct therapy in relation with literature cases, and including new techniques for post-operative outcomes, such as injectable soft-tissue bulking agent performed in the last years to ameliorate dysphonia after nerve trunk injury.