A rare case of cervical sympathetic schwannoma

Schwannomas are benign neoplasms arising from myelinating Schwann cells. Nerve sheath tumours arising from the sympathetic chain are very sporadic, with very few cases reported that presented with Horner’s syndrome. The authors describe its radiological and histological features and surgical management in this case report. A sixty-eight-year-old man presented with throat discomfort and hoarseness of voice for three months. He had a palpable mass on the left side in the submandibular region on neck examination. The patient had left recurrent laryngeal nerve palsy and Horner’s syndrome on general examination. MRI with contrast was performed to see the extent of the tumour. Exploratory cervicotomy was performed; the tumour was seen originating from the lower cervical sympathetic chain posterior to the carotid sheath. Histopathological examination confirmed the diagnosis of cervical sympathetic schwannoma. Cervical sympathetic schwannoma is a benign, slow-growing neoplasm with varied presentation. Presentation with Horner’s syndrome is a rare but reported presentation. Radiological imaging plays a vital role in the identification and surgical management. For symptomatic tumours, exploratory cervicotomy is the preferred approach for its wide exposure. Histopathological examination is confirmatory for the diagnosis.