Tawfeeq Essa, AlSaidan Lulwah, Hayat Jafar, AlAbdulrahim Bodour, Sarkhouh Mariam, Al-Sihan Mutlaq
Department of Otolaryngology, Head and Neck Surgery, Zain Hospital, Shuwaikh Medical Area, Kuwait.
Department of Otolaryngology, Head and Neck Surgery, Zain Hospital, Shuwaikh Medical Area, Kuwait.
Int J Surg Case Rep. 2023 Aug;109:108629. doi: 10.1016/j.ijscr.2023.108629. Epub 2023 Aug 6.
Schwannomas are tumors of the nerve sheath that consist of Schwann cells that are often described as slow-growing. Glossopharyngeal schwannomas are rare tumors present in the region of the posterior fossa, with limited case reports present in literature. While patients may present asymptomatically, some present with vestibulocochlear symptoms or lower cranial nerve dysfunction.
We report an extremely rare case of a left para-pharyngeal carotid space glossopharyngeal schwannoma in a 26-year-old female. The presentation was a 3-month left sided neck swelling and a hoarse voice. Radiological investigations were completed (neck ultrasound; CT; MRI scans). Investigations revealed a solid lesion measuring about 29 × 10 mm. The final decision was to excise the mass under microsurgery.
CN 9-11 schwannomas are often called jugular foramen schwannomas. Intraoperatively, these get differentiated as glossopharyngeal schwannomas. Diagnosis involves a physical examination, a detailed history, audiological assessments, and radiological investigations. While MRI scans are known as the most effective pre-operative diagnostic test, cases are in majority discovered intra-operatively. Surgical excision is the recommended approach. Post-operative recurrence is rare. Pre-operative diagnosis is often difficult due to the rarity and similarly presenting differential diagnoses.
Schwannomas of the glossopharyngeal nerve are extremely rare tumors that may present with lower cranial nerve or vestibulocochlear deficits. Magnetic resonance imaging is a useful tool in diagnosing this unordinary tumor. This case report intends to provide further data regarding the clinical presentation, the patient population, and the diagnostic and surgical approach in dealing with this incredibly rare tumor.
施万细胞瘤是神经鞘瘤，由通常被描述为生长缓慢的施万细胞组成。舌咽神经施万细胞瘤是后颅窝区域的罕见肿瘤，文献中仅有有限的病例报告。虽然患者可能无症状，但有些患者会出现前庭蜗神经症状或低位颅神经功能障碍。
我们报告了一例极为罕见的26岁女性左侧咽旁颈动脉间隙舌咽神经施万细胞瘤病例。表现为左侧颈部肿胀3个月及声音嘶哑。完成了影像学检查（颈部超声、CT、MRI扫描）。检查发现一个实性病变，大小约为29×10毫米。最终决定在显微镜下切除肿块。
第9 - 11对颅神经施万细胞瘤通常被称为颈静脉孔施万细胞瘤。术中，这些肿瘤可被鉴别为舌咽神经施万细胞瘤。诊断包括体格检查、详细病史、听力学评估和影像学检查。虽然MRI扫描是最有效的术前诊断检查，但大多数病例是在术中发现的。推荐的治疗方法是手术切除。术后复发罕见。由于其罕见性以及类似表现的鉴别诊断，术前诊断往往困难。
舌咽神经施万细胞瘤是极为罕见的肿瘤，可能表现为低位颅神经或前庭蜗神经功能缺损。磁共振成像在诊断这种罕见肿瘤方面是一种有用的工具。本病例报告旨在提供有关临床表现、患者群体以及处理这种极其罕见肿瘤的诊断和手术方法的进一步数据。
