Malignant schwannoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Neck swelling.

Patient Data

Age: 65 years
Gender: Male
ct

Well defined large mass located in left side of neck, specially in carotid and submandibular spaces and causing airway midline shift. On non-contrast images mild calcification is noted at inner portion of the mass.

After contrast injection, marked enhancement of the mass is seen with some areas of hypodensity which can be due to necrotic changes. Common carotid artery and main branches encased with the mass, but there is no evidence of vascular invasion. Several lymphadenopathies also is seen at adjacent neck spaces.

Fatty replacement of left half of the tongue is consistent of hypoglossal nerve involvement.

Case Discussion

Main differential diagnosis for hypervascular large neck mass in 66 year old patient include:

Histopathology findings compatible with malignant schwannoma.

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