Schwannoma of cervical sympathetic chain: assessment and management Schwannoma della catena del simpatico cervicale: accertamenti e trattamento

Summary Schwannoma arising from the cervical sympathetic chain is an uncommon benign nerve tumour. This tumour most often pre- sents as an asymptomatic solitary neck mass, with slow-grow- ing and rare malignant degeneration. Definitive pre-operative diagnosis may be difficult and investigations are not usually helpful. The carotid artery and internal jugular vein may be displaced anterior-laterally. Diagnosis relies on clinical suspi- cion and confirmation is often obtained by means of surgical pathology. Surgical excision is the treatment of choice for this tumour, with recurrence being rare. Horner's syndrome is a common post-operative neurological consequence, but does not appear to cause problems to the patient. The case is de- scribed of a 42-year-old male who presented an asymptomatic left neck mass. Diagnostic studies included computed tomog- raphy, magnetic resonance imaging, and ultrasound which confirmed a circumscribed mass in the upper left portion of the neck next to the thyroid gland. The mass was excised through a transverse left cervical skin incision. Post-operatively the pa- tient showed clinical findings of Horner's syndrome. The pathologic and radiological evaluations, treatment and post- operative complications of this neoplasm are discussed.