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CASE REPORT
Cystic schwannoma of the recurrent laryngeal nerve: a rare finding posing diagnostic difficulties
  1. Rowan Knulst,
  2. Willem-Maarten Bosman,
  3. Ewan D Ritchie,
  4. Andy da Costa
  1. Department of Surgery, Rijnland Ziekenhuis, Leiderdorp, The Netherlands
  1. Correspondence to Dr Ewan D Ritchie, e.ritchie{at}rijnland.nl

Summary

A 49-year-old woman with a painless mass in the neck was examined by the surgeon. Imaging and cytology prior to surgery suggested the mass to be either a thyroid cyst or a branchial cleft cyst. After surgery, the patient reported a hoarse voice and the pathologist confirmed the removed lesion to be a cystic schwannoma of the left recurrent laryngeal nerve. The inconclusive imaging results, combined with colloid-like material in the punctate should prompt the investigator to include cystic schwannoma in the differential diagnosis. With the probability of a neurogenic origin of the mass in mind, nerve-sparing surgery can be performed. As a future prospect, positron emission tomography scans are mentioned as a modality with possibilities to discriminate a cystic schwannoma from other common cystic lesions.

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