Cervical Vagus Nerve Schwannoma: A Rare Case Report (Diagnostic and Therapeutic Strategy)

Fadoua EM

Published on: 2024-11-08

Abstract

Introduction: Schwannomas originating from the Schwann cells are a rather uncommon benign tumor. Schwannomas often don't cause any symptoms, but larger tumors may cause vague symptoms because they squeeze nearby anatomical tissues. The pathognomonic symptoms of vagus nerve schwannomas are isolated neck masses, hoarseness of voice, and paroxysmal coughing that occurs upon palpation. Imaging tests may be quite important in making a difficult preoperative diagnosis. The preferred course of treatment is surgery that removes the tumor entirely. Nerve damage during surgical resection is associated with significant morbidity.

Case Report: We report a case of vagus nerve schwannoma in a male adult patient in this study with a history of a mass in the right lateral neck area. Patients with no specific pathological antecedents. The history of her illness goes back to 1 year with the appearance of a right latero cervical mass progressively increasing in volume with no inflammatory signs opposite, no associated compressive signs and no fistulization to the skin. ; However, the patient had begun to experience some nonspecific symptoms in the previous year. The main complaints were mild hoarseness of voice, episodes of bradycardia. Pathological examination demonstrated the diagnosis of schwannoma.

Discussion: Vagal schwannoma is a rare clinical entity that should be considered a differential for slow-growing neck lump. The identification and treatment of vagal schwannomas are undoubtedly difficult in the clinical setting. In actuality, symptoms are typically non-specific, which could cause delays in diagnosis. Imaging is a very helpful modality for diagnosis and surgical planning .Furthermore, it should be carefully addressed because post-operative sequelae, such as vagal nerve injury, still represent important issues, even though complete surgical resection is the standard therapeutic method. We have offered a vagal schwannomas care algorithm based on a combination of scientific data from the literature and our clinical expertise.

Conclusion: Vagus nerve schwannoma excision and manipulation can result in dangerous bradycardia and aberrant ECG readings. As such, the patient needs to be closely observed. It is important for anesthetists to be prepared for such situations in order to avoid hemodynamic instability. It is necessary for anesthetists and surgeons to collaborate and communicate.