Cervical Accessory Nerve Schwannoma: A Case Report

Abstract

45% have an extracranial presentation in the neck area and can affect peripheral nerves; cranial nerves V, VII, X, XI, and XII; and sympathetic chains. 3 Previous studies have found that the most affected nerve is cranial nerve X or vagus nerve implicated in 37%, with the least affected being cranial nerve XI or accessory nerve in only 4% of cases. 4 Age at presentation is wide-ranging, reported in most series from 19 to 49 years, although it has been reported from 10 up to 70 years, with a mean of 43 ± 15 years, with a slight male predominance. 5,6 The most common presentation from this type of tumors is a painless, slow-growing tumor in the cervical area, but can have a different presentation depending on the involved nerve. 7 Schwannomas are tumors derived from Schwann cells that produce the myelin sheath that covers peripheral nerves, uncommon in the head and neck area. These rare tumors can arise from cranial nerves in their extracranial pathways, from sympathetic chains and peripheral nerves. We report the case of a female patient with a cervical accessory nerve schwannoma and its computed tomography (CT) scan, magnetic resonance imaging (MRI), and histopathologic findings. Surgical excision avoiding nerve manipulation continues to be the first-line therapy in these cases, to avoid or minimize nerve-related complications.