 |
Quiz of the month | ||
|
|||
|
|||
|
|||
CT Case of the Month |
Clinical Details: A 45 yrs female came with h/o swelling in neck on left side with change in voice since 2 months
 |
 |
USG neck : showing well defined heterogenous mass lesion in anterior triangle of the neck, displacing the carotid artery anteriomedially and showing mild vascularity. |
 |
 |
 |
 |
NECT & CECT : well defined heterogeneously mildly enhancing mass lesion ,in left carotid space displacing internal carotid artery anteromedially & internal jugular vein posteromedially &displacing the styloid process laterally. |
DIFFERENTIAL DIAGNOSIS: Vagal schwannoma
DISCUSSION : Schwannomas are benign, slow-growing neoplasms that can arise from any peripheral, spinal or cranial nerve, excluding the optic and olfactory nerves.Parapharyngeal schwannoma arise from the last four cranial nerves and the cervical sympathetic chain.Schwannomas of the vagus nerve are very rare.
Schwannomas are benign, encapsulated nerve sheath tumours which enlarge slowly and cause impingement on adjacent structures
CECT : Schwannomas are usually ovoid or fusiform masses that typically displace the internal carotid artery anteriorly when arising from the vagus nerve. This tumour typically has well-delineated margins with a higher attenuation than adjacent muscle on a contrast enhanced CT scan, but may be isodense or, less commonly, of lower attenuation than adjacent muscle. Approximately one third of schwannoma enhance significantly on CT. By comparison, neurofibromas undergo significant fatty degeneration and, on imaging, may appear as predominantly lipid-containing lesions
MRI : MRI of schwannoma typically demonstrates a mass of intermediate signal intensity on T1weighted images and increased signal intensity on T2 weighted images, again with smooth well-delineated contours and homogeneous overall appearance. Although areas of signal void may occasionally be detected, these lesions do not have the salt-and-pepper appearance noted with paragangliomas.
References:
-
Zachariades N, Skoura C, Papageorgiou G, Chrissomali E. Giant ancient neurilemmoma of the cervical region: report of case. J Oral Maxillofac Surg 2001; 59: 668–672.
-
Cunningham Jr LL, Warner MR. Schwannoma of the vagus nerve first diagnosed as a parotid tumor. J OralMaxillofac Surg 2003; 61: 141–144.
-
Yusuf H, Fajemisin OA, McWilliams LJ. Neurilemmoma involving
the maxillary sinus. Br J Oral Maxillofac Surg 1989; 27: 506–511.
Dr Aswini Bakade (junior resident). Dr Sneha Chaudhary(junior resident). Dr Vijay k(junior resident). Dr Shilpa Patil(junior resident). Dr Kiran Sargar(junior resident). |
Stay updated with campus
news and events.
Department of Radiodiagnosis, Government Medical College, Nagpur
