A case of greater occipital nerve schwannoma causing neuralgia

Year 2008, Volume: 18 Issue: 4, 253 - 256, 30.08.2008

Ahmet Ural Alper Ceylan Erdoğan İnal Fatih Çelenk

Abstract

Schwannomas are common tumors of the head and neck region, but they rarely develop in the suboccipital region. A 34-year-old woman presented with a left suboccipital mass causing local pain and neck stiffness. Following physical examination, fine needle aspiration biopsy was performed, which revealed benign cytology. In the light of preoperative radiologic examination and intraoperative observations, the lesion was thought to originate from the greater occipital nerve. Following complete excision of the lesion, histopathological diagnosis was made as schwannoma. Apart from mild neck stiffness and transient local paresthesia in the early postoperative period, no complications were seen during a two-year follow-up period.

Keywords

Neuralgia/etiology, neurilemmoma/complications/surgery, peripheral nervous system neoplasms, spinal nerves

Nöraljiye yol açan büyük oksipital sinir schwannoması: Olgu sunumu

Abstract

Schwannomalar baş ve boyun bölgesinin sık görü- len tümörleri olmasına karşın, suboksipital bölge- de görülmeleri nadirdir. Otuz dört yaşında kadın hasta, sol suboksipital bölgede kitle, lokal ağrı ve boyunda tutukluk yakınmalarıyla kliniğimize baş- vurdu. Muayene sonrası yapılan ince iğne aspiras- yon biyopsi sonucu benign sitoloji olarak bildirildi. Radyolojik değerlendirme ve ameliyat sırası bulgular ışığında majör oksipital sinirden kaynaklandığı düşü- nülen kitle tam olarak eksize edildi ve histopatolojik tanı schwannoma olarak bildirildi. Ameliyat sonrası erken dönemde boyunda hafif tutukluk ve geçici lokal parestezi dışında, hastanın iki yıllık izlemi sıra- sında başka sorun görülmedi

References

• Zachariades N. Schwannoma of the oral cavity. Review of the literature and report of a case. J Oral Med 1984;39:41-3.
• Williams HK, Cannell H, Silvester K, Williams DM. Neurilemmoma of the head and neck. Br J Oral Maxillofac Surg 1993;31:32-5.
• Yusuf H, Fajemisin OA, McWilliam LJ. Neurilemmoma involving the maxillary sinus: a case report. Br J Oral Maxillofac Surg 1989;27:506-11.
• Gibbons SD, Wiesenfeld D, Millar H, Busmanis IA. Removal of a retromaxillary schwannoma via a tem- poral approach. J Oral Maxillofac Surg 1991;49:191-3.
• Bradley N, Bowerman JE. Parapharyngeal neurilem- momas. Br J Oral Maxillofac Surg 1989;27:139-46.
• Ballesteros-Del Rio B, Ares-Luque A, Tejada-Garcia J, Muela-Molinero A. Occipital (Arnold) neuralgia secondary to greater occipital nerve schwannoma. Headache 2003;43:804-7.
• Benzoni E, Cojutti A, Intini S, Uzzau A, Bresadola F. Schwannoma of the sympathetic cervical chain pre- senting as a lateral cervical mass. Tumori 2003;89:211-2.
• Zachariades N, Skoura C, Papageorgiou G, Chrissomali E. Giant ancient neurilemmoma of the cervical region: report of case. J Oral Maxillofac Surg 2001;59:668-72.
• Hood RJ, Reibel JF, Jensen ME, Levine PA. Schwannoma of the cervical sympathetic chain. The Virginia experi- ence. Ann Otol Rhinol Laryngol 2000;109:48-51.
• Hirabayashi S, Sakurai A, Fukuda O. Neurilemoma of the ansa cervicalis. Plast Reconstr Surg 1987;79:809-11.
• Bektas D, Caylan R. Bilateral hypoglossal schwan- noma: a radiologic diagnosis. Kulak Burun Bogaz Ihtis Derg 2004;12:45-7.
• Guerra MF, Campo FR, de Artinano FO, Perez JS. Schwannoma of the brachial plexus: an unusual cause for a cervical mass. J Oral Maxillofac Surg 2001;59:942-4.
• Keleş E, Yalçın Ş, Sakallıoğlu Ö, Dağlı AF. Üst ser- vikal sempatik zincirden kaynaklanan periferik para- farengeal schwannoma: olgu sunumu. KBB-Forum 2006;5:54-7.
• Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, Brennan P, O’Dwyer AJ, et al. Head and neck schwanno- mas - a 10 year review. J Laryngol Otol 2000;114:119-24.
• Nuss DW, Battalora PA. Pathologic quiz case 2. Schwannoma of the cervical plexus. Arch Otolaryngol Head Neck Surg 1990;116:224-5.
• Abramowitz J, Dion JE, Jensen ME, Lones M, Duckwiler GR, Vinuela F, et al. Angiographic diagnosis and man- agement of head and neck schwannomas. AJNR Am J Neuroradiol 1991;12:977-84.