Cervical sympathetic chain schwannoma presenting as a carotid body tumor

Nerve sheath tumours arising from the sympathetic chain are extremely rare and are a diagnostic challenge. Schwannomas are benign nerve sheath tumours deriving from Schwann cells that occur in the head and neck region in 25-45% of cases. Cervical lesions originate from spinal nerves, the last four cranial nerve roots, or occasionally from the sympathetic chain. Carotid body tumour (CBT), the most common tumour of the carotid bifurcation, presents as a pulsatile mass. Cervical sympathetic chain (CSC) schwannomas are slow growing lesions and may appear pulsatile due to the displacement of vascular structures by the non-vascular mass and thus may mimic a CBT. We here in discuss a case of 22year old female, who underwent surgical resection of a mass at carotid bifurcation, presuming a CBT, but postoperative histopathological examination revealed it a schwannoma.