Acta Medica Iranica 2014. 52(7):569-74.

Cervical sympathetic schwannoma: report of two cases and review of the literature.
Iraj Nazari, Maryam H Esfehani, Mohsen Nouri, Ahmad R Naeemi, Javad Salimi, Mohammad R Zafarghandi


This study describes two cases of cervical sympathetic schwannoma operated at department of vascular surgery and review the literature to clarify the demographic, diagnostic, and therapeutic features of these rare lesions for the first time. Two 32- and 59-year-old ladies both presenting with a painless cervical mass were referred to our service with the initial diagnosis of carotid body tumor. At the operation, mobile masses which could be easily dissected from the surrounding arteries and veins, except for the cervical sympathetic trunk were observed. Micro-surgical techniques helped us with removing the lesions with saving the sympathetic trunk in both cases. No permanent deficits were observed post-operatively in patients. Angiographic studies can provide the only pre-operative clues to diagnose a sympathetic schwannoma. Total removal of the lesion at the expense of sacrificing the sympathetic nerve is associated with minimal neurologic deficits which are well tolerated by the patient.


Schwannoma; Sympathetic; Tumor; Cervical; Angiography

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Al-Mashat FM. Sympathetic chain Schwannoma. Saudi Med J 2009;30(1):154-6.

Aydin S, Sanli A, Tasdemir O, et al. Horner’s Syndrome Post-Excision of a Huge Cervical Sympathetic Chain Schwannoma. Turk J Med Sci 2007;37(3):185-90.

Aygenc E, Selcuk A, Ozdem C. Hypervascular parapharyngeal schwannoma:an unusual case. Auris Nasus Larynx 2002;29(2):215-7.

Bocciolini C, Dall’olio D, Cavazza S, et al. Schwannoma of cervical sympathetic chain: assessment and management. Acta Otorhinolaryngol Ital 2005;25(3):191-4.

Burduk PK, Dalke K, Szukalski J, et al. Cervical sympathetic chain neurilemmoma--a case report. Otolaryngol Pol 2006;60(1):101-3.

Cashman E, Skinner LJ, Timon C. Thyroid Swelling: An Unusual Presentation of a Cervical Sympathetic Chain Schwannoma. Medscape J Med 2008;10(8):201.

Casserly P, Kiely P, Fenton JE. Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome. Eur Arch Otorhinolaryngol 2009;266(10):1659-62.

Cheshire WP, Odell JA, Woodward TA, et al. Cervical Sympathetic Neuralgia Arising From a Schwannoma. Headache 2007;47(3):444-6.

Fornaro R, Frascio M, Stabilini C, et al. Excision of a schwannoma of the neck: surgical technique. G Chir 2006;27(11-12):428-32.

Ganesan S, Harar RP, Owen RA, et al. Horner's syndrome:a rare presentation of cervical sympathetic chain schwannoma. J Laryngol Otol 1997;111(5):493-5.

Giustolisi N, Pulvirenti D, Neri S. Horner's syndrome in a patient with cervical sympathetic chain schwannoma. Minerva Chir 2006;61(3):273-5.

Hood RJ, Reibel JF, Jansen ME, et al. Schwannoma of the cervical sympathetic chain. The Virginia experience. Ann Otol Rhinol Laryngol 2000;109(1):48-51.

Jain S, Houseknecht K, Rojiani AM, et al. Management of nerve sheath tumors arising in the sympathetic chain. Cancer Control 2008;15(4):352-7.

Kahraman A, Yildirim I, Kiliç MA, et al. Horner's syndrome from giant schwannoma of the cervical sympathetic chain: case report. B-ENT 2009;5(2):111-4.

Kamal A, Abd El-Fattah AM, Tawfik A, et al. Cervical sympathetic schwannoma with postoperative first bite syndrome. Eur Arch Otorhinolaryngol 2007;264(9):1109-11.

Kang GC, Soo KC, Lim DT. Extracranial non-vestibular head and neck schwannomas: a ten-year experience. Ann Acad Med Singapore 2007;36(4):233-8.

Kara CO, Topuz B. Horner's syndrome after excision of cervical sympathetic chain schwannoma. Otolaryngol Head Neck Surg 2002;127(1):127-8.

Karpati RL, Loevner LA, Cunning DM, et al. Synchronous schwannomas of the hypoglossal nerve and cervical sympathetic chain. AJR Am J Roentgenol 1998;171(6):1505-7.

Lin CC, Wang CC, Liu SA, et al. Cervical sympathetic chain schwannoma. J Formos Med Assoc 2007;106(11):956-60.

Mandel L, Syrop SB. First-Bite Syndrome after Parapharyngeal Surgery for Cervical Schwannoma. J Am Dent Assoc 2008;139(11);1480-3.

Ozlugedik S, Ozcan M, Unal T, et al. Cervical sympathetic chain schwannoma: two different clinical presentations. Tumori 2007;93(3):305-7.

Panneton JM, Rusnak BW. Cervical sympathetic chain schwannomas masquerading as carotid body tumors. Ann Vasc Surg 2000;14(5):519-24.

Politi M, Toro C, Cian R, et al. Horner's syndrome due to a large schwannoma of the cervical sympathetic chain: report of case. J Oral Maxillofac Surg 2005;63(5):707-10.

Rohaizak M, Meah FA. Cervical Sympathetic Schwannoma Simulating a Thyroid Nodule. Med J Malaysia 2002;57(2):218-20.

Rosner M, Fisher W, Mulligan L. Cervical sympathetic schwannoma: case report. Neurosurgery 2001;49(6):1452-4.

Souza JW, Williams JT, Dalton ML, et al. Schwannoma of the cervical sympathetic chain: it's not a carotid body tumor. Am Surg 2000;66(1):52-5.

Tomita T, Ozawa H, Sakamoto K, et al. Diagnosis and management of cervical sympathetic chain schwannoma: a review of 9 cases. Acta Otolaryngol 2009;129(3):324-9.

Uzun L, Ugur MB, Ozdemir H. Cervical sympathetic chain schwannoma mimicking a carotid body tumor: a case report. Tumori 2005;91(1):84-6.

Wax MK, Shiley SG, Robinson JL, et al. Cervical sympathetic chain schwannoma. Laryngoscope 2004;114(12):2210-3.

Leu YS, Chang KC. Extracranial Head and Neck Schwannomas: A Review of 8 Years Experience. Acta Otolaryngol 2002;122(4):435-7.

Sakao T, Noguchi S, Murakami N, et al. Neurilemmoma of the neck;a report of 35 cases. Nihon Geka Gakkai Zasshi 1990;91(3):407-10.

de Araujo CE, Ramos DM, Moyses RA, et al. Neck nerve trunks schwannomas: clinical features and postoperative neurologic outcome. Laryngoscope 2008;118(9):1579-82.

Takimoto T, Katoh H, Umeda R. Parapharyngeal schwannoma of the cervical sympathetic chain in a child. Int J Pediatr Otorhinolaryngol 1989;18(1):53-8.

Saito DM, Glastonbury CM, El-Sayed IH, et al. Parapharyngeal space schwannomas:preoperative imaging determination of the nerve of origin. Arch Otolaryngol Head Neck Surg 2007;133(7):662-7.

Wang CP, Hsiao JK, Ko JY. Splaying of the carotid bifurcation caused by a cervical sympathetic chain schwannoma. Ann Otol Rhinol Laryngol 2004;113(9):696-9.

Furukawa M, Furukawa MK, Katoh K, et al. Differentiation between schwannoma of the vagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis. Laryngoscope 1996;106(12 Pt 1):1548-52.

Yang BB, Jiang H, Chang HY. Malignant triton tumour of the parapharyngeal space: a case arising from the cervical sympathetic nerve. J Laryngol Otol 2008;122(5):531-4.

Nguyen CT, Tan J, Blackwell KE, et al. Primary melanocytic schwannoma of cervical sympathetic chain. Head Neck 2000;22(2):195-9.

Hood RJ, Reibel JF, Jensen ME, et al. Schwannoma of the cervical sympathetic chain. The Virginia experience. Ann Otol Rhinol Laryngol 2000;109(1):48-51.


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