Diagnostic Dilemma: Presenting as A Posterior Neck Swelling

Neck swelling is a common presentation in the general population and has a number of possible causes. Lymph nodes are the commonest among all. Schwannomas are benign slow growing tumors that arise from the Schwann cells of nerve, also called neurilemmoma. Head and Neck schwannomas usually present as solitary with well demarcated lesions. These tumors usually remain asymptomatic but present as slowly enlarging neck masses. Its origin is only determined during surgical procedure along the course and distribution of the nerve. Preoperative diagnosis is usually made by physical examination and aided by ultrasonography, magnetic resonance imaging or computed tomography and fine needle aspiration cytology but open biopsy is not recommended. The main stay of treatment is complete intracapsular excision with preserving the nerve of origin.