Case report of a malignant schwannoma in the neck with rare pathological findings

Abstract

In this report, we describe a rare case of a malignant transformation in an ancient schwannoma arising in the right side of the neck of a 51-year-old man. The patient was referred to our hospital because of a mass that had been present for three years. The mass, measuring about 4 x 2 cm, was elastic and hard, relatively well demarcated, and movable upon palpation. Aspiration cytology was performed, but the diagnosis was unclear histologically. The patient was placed under general anesthesia and the tumor was totally excised. The tumor, which was easily excised, was connected to the sympathetic nerve at both poles. The histological diagnosis was a malignant transformation in an ancient schwannoma. The patient showed no clinical manifestations suggesting neurofibromatosis. Three months after the operation, a recurrent tumor, which was not resectable, was discovered extending deep into the skull base. The patient underwent two operations and two courses of radiation therapy, but the tumor metastasized to the lung and liver. He died of pulmonary failure eleven months after the initial treatment.