title: An unusual giant schwannoma of cervical sympathetic chain: a case report.
abstract: BACKGROUND
  Schwannomas are benign, well-differentiated tumors that originate from Schwann cells. Involvement of the cervical sympathetic nerve is relatively rare. Computed tomography is indispensable for the diagnosis. The treatment is surgical. Histological examination confirms the diagnosis. Horner's syndrome postoperatively is supportive of the diagnosis. The rarity of giant cervical sympathetic chain schwannoma made the case of our patient interesting to report. Furthermore, our patient's immense tumor size is very rare, and we could not find any similar report in the literature. Cervical sympathetic chain schwannoma is frequently confused with schwannoma of the vagus nerve on clinical and radiological examination, and its diagnosis can therefore be challenging for clinicians, radiologists, and pathologists.
  
  
  METHODS
  We report a rare case of cervical schwannoma in a 40-year-old Moroccan woman who presented with a large parapharyngeal mass. Computed tomography revealed a giant, heterogeneous, well-defined mass measuring 110 × 100 × 147 mm, occupying the right carotid triangle, and descending to the superior mediastinum. Surgical excision with a transcervical approach was done. Histological examination confirmed the diagnosis. The patient's postoperative course was marked by Horner's syndrome.
  
  
  CONCLUSIONS
  Cervical sympathetic chain schwannoma is a rare, benign tumor. It should be considered in the differential diagnosis in patients presenting with a lateral neck mass. Surgical exploration must be discussed for a tumor with a large volume.
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco. adouly.taoufik@gmail.com.
authors.forename: Taoufik
authors.initials: T
authors.lastname: Adouly
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Choaib
authors.initials: C
authors.lastname: Adnane
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Tarek
authors.initials: T
authors.lastname: Oubahmane
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Sami
authors.initials: S
authors.lastname: Rouadi
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Redallah
authors.initials: R
authors.lastname: Abada
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Roubal
authors.affiliation: Department of ENT, Hopital 20 Août, Ibn Rochd University Hospital, Casablanca, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mahtar
mesh_terms: D000328:Adult; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000601:surgery; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D013564:Sympathetic Nervous System
references.citation: Acta Otolaryngol. 2009 Mar;129(3):324-9
references.pmid: 18607892
references.citation: J Laryngol Otol. 2000 Feb;114(2):119-24
references.pmid: 10748827
references.citation: Otolaryngol Head Neck Surg. 1997 Dec;117(6):S206-10
references.pmid: 9419150
references.citation: Acta Otorhinolaryngol Ital. 2012 Apr;32(2):133-6
references.pmid: 22767977
references.citation: Laryngoscope. 1996 Dec;106(12 Pt 1):1548-52
references.pmid: 8948621
references.citation: Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(3):292-4
references.pmid: 22754814
references.citation: Eur Arch Otorhinolaryngol. 2009 Oct;266(10):1659-62
references.pmid: 19130071
references.citation: AJNR Am J Neuroradiol. 2010 Sep;31(8):1408-12
references.pmid: 20616174