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Academia Mexicana de Neurología, A.C.

2015, Number 4

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Rev Mex Neuroci 2015; 16 (4)

Retrostyloid parapharyngeal cervical cystic schwannoma of the vagus nerve

Gutiérrez- Sumillera M, Vallés M, Barbieri G, Villanueva V, Gonzálvez M, Veiga P, Rodríguez MÁ

Language: Spanish
References: 21
Page: 31-37
PDF size: 454.97 Kb.


ABSTRACT

Introduction: Cervical cystic schwannoma or neurilemmoma of the vagus nerve is a benign, painless, slow-growing mesenquimatous tumor that develops from Schwann cells sheath.
Case report: A 59-year-old man came to us with a right pterygopalatine tumor with an estimated size on neuroimaging of 7 x 4 x 6 cm. The diagnosis was compatible with cystic schwannoma of the vagus nerve located on the right retrostyloid parapharyngeal space. It was completely removed with a satisfactory postoperative control and no local-regional relapse signs.
Conclusion: With a challenging and late diagnosis, due to lack of neurological symptomatology, the diagnosis of this tumours in such a location requires clinician suspicion and correct diagnostic approaches. Magnetic resonance imaging and computed tomography with intravenous contrast are recommended to accomplish this task. Definitive diagnosis will be anathomopatologic after the complete surgical excision of the tumour. If possible, preservation of neural pathway is preferred. This is however not an option in over 50% of the cases due to the irremediable nervous lesion for definitive treatment. Functional consequences from the surgery are usual and should be known by the patient.


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