Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome.
AffiliationDepartment of ENT, Mid-Western Regional Hospital, Limerick, Ireland., firstname.lastname@example.org
MeSHAutonomic Nervous System Diseases/*diagnosis/pathology/surgery
Carotid Artery, External/pathology
Carotid Artery, Internal/pathology
Carotid Body Tumor/*diagnosis
Head and Neck Neoplasms/blood supply/*diagnosis/pathology/surgery
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Peripheral Nervous System Neoplasms/blood supply/*diagnosis/pathology/surgery
Tomography, X-Ray Computed
MetadataShow full item record
CitationEur Arch Otorhinolaryngol. 2009 Oct;266(10):1659-62. Epub 2009 Jan 8.
JournalEuropean archives of oto-rhino-laryngology : official journal of the European, Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the, German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
AbstractCarotid body tumours (CBT) are the most common tumours at the carotid bifurcation. Widening of the bifurcation is usually demonstrated on conventional angiography. This sign may also be produced by a schwannoma of the cervical sympathetic plexus. A 45-year-old patient presented with a neck mass. Investigations included contrast-enhanced CT, MRI and magnetic resonance arteriography with contrast enhancement. Radiologically, the mass was considered to be a CBT due to vascular enhancement and splaying of the internal and external carotid arteries. Intraoperatively, it was determined to be a cervical sympathetic chain schwannoma (CSCS). The patient had a postoperative complication of first-bite syndrome (FBS).Although rare, CSCS should be considered in the differential diagnosis for tumours at the carotid bifurcation. Damage to the sympathetic innervation to the parotid gland can result in severe postoperative pain characterised by FBS and should be considered in all patients undergoing surgery involving the parapharyngeal space.
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