Cystic schwannoma of the recurrent laryngeal nerve: a rare finding posing diagnostic difficulties.
A 49-year-old woman with a painless mass in the neck was examined by the surgeon. Imaging and cytology prior to surgery suggested the mass to be either a thyroid cyst or a branchial cleft cyst. After surgery, the patient reported a hoarse voice and the pathologist confirmed the removed lesion to be a cystic schwannoma of the left recurrent laryngeal nerve. The inconclusive imaging results, combined with colloid-like material in the punctate should prompt the investigator to include cystic schwannoma in the differential diagnosis. With the probability of a neurogenic origin of the mass in mind, nerve-sparing surgery can be performed. As a future prospect, positron emission tomography scans are mentioned as a modality with possibilities to discriminate a cystic schwannoma from other common cystic lesions.
Department of Surgery, Rijnland Ziekenhuis, Leiderdorp, The Netherlands.
Rowan
R
Knulst
Willem-Maarten
WM
Bosman
Ewan D
ED
Ritchie
Andy
A
da Costa
D044963:Biopsy, Fine-Needle; D001935:Branchioma / Q000175:diagnosis*; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003560:Cysts / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery; D012009:Recurrent Laryngeal Nerve / Q000000981:diagnostic imaging / Q000601:surgery*; D013959:Thyroid Diseases / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000209:etiology