CASE 245: CERVICAL VAGUS NERVE SCHWANNOMA, Dr PHAN THANH HAI - Dr LAM CAM TU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 51yo detected lateral left neck mass, no pain (see foto ).

ENT doctor did endoscopy for rule out a cavum cancer, and FNAC did not detect cancer cell metastasis to this mass.

Ultrasound report was an ellipse mass of 3 x 5 cm,  well-bordered,  hypoechoic, hypovascular with small cystic formation which deplaced the CCA and internal jugular vein (IJV) that well confirmed by 3D vascular CT angio (see 4 CT pictures).

Discussion:  This 51 yo woman with the mass in upper portion of left lateral neck, painless for a long time suggesting malignancy.
Ultrasound is the fist choice for diagnosis after consultation of ENT doctor. Ultrasound picture is like a cystic mass, hypovascular supplied which situated  between CCA and  internal jugular vein. The tumor developed in the sheath of carotid artery and expansion. MSCT 3D angio shows very well  the  displacement of  CCA and IJV,  that is the key for  diagnosis;  this tumor developed from carotid sheath like schwannoma (neurilemnoma).  

Operation for  removing  this  tumor easily;  macroscopic view shows capsule thickening  tissue that is  soft,  like brain tissue.

Microscopic report is a schwannoma of vagus nerve.

REFERENCE:

Case report pdf