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      Schwannoma del nervio vago Translated title: Vagus-nerve schwannoma

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          Abstract

          Resumen Introducción: los schwannomas, también llamados neurilemomas o neurinomas, son tumores de origen neuroectodérmico, encapsulados y benignos, que generalmente aparecen como una masa laterocervical asintomática de crecimiento lento. Son pocos frecuentes en el área de cabeza y cuello. Caso clínico: mujer de 39 años con una historia de un año de evolución de una masa cervical derecha de crecimiento lento, pulsátil, dolorosa y móvil en el lado derecho del cuello. La imagen de la angiotomografía computarizada preoperatoria demostró que la masa involucraba la bifurcación carotídea, compatible con un paraganglioma carotídeo. La disección cuidadosa a través de una cervicotomía longitudinal mostró que la masa surgía de un único fascículo del nervio vago. La masa se envió a anatomía patológica con el resultado de schwannoma. En el posoperatorio la paciente presentó una función sensorial y motora del vago normal, con un leve síndrome de Horner. Discusión: los tumores nerviosos del cuello surgen a partir de grandes troncos nerviosos, los IX, X, XI y XII pares craneales, el simpático cervical, el plexo cervical y el plexo braquial. El nervio vago es un lugar infrecuente de aparición, con muy pocos casos reportados. Son lesiones de diagnóstico preoperatorio difícil, cuyo tratamiento de elección es la exéresis quirúrgica; en ocasiones, es difícil conservar el nervio de origen.

          Translated abstract

          Abstract Introduction: schwannomas, neurilemomas or neurinomas, are benign, encapsulated, neuroectodermal tumors that generally appear as a slow-growing, asymptomatic laterocervical mass. They are rare in the head and neck area. Clinical case: a 39-year-old woman with a one-year history of a slowly enlarging, pulsatile, painful and movable right cervical mass on the right side of the neck. Preoperative computed angiotomography image demonstrated that the mass involved the carotid bifurcation compatible with a carotid paraganglioma. Careful dissection through a longitudinal cervicotomy, showed that the mass arose from a single fascicle of the vagus nerve. The mass was sent to the pathologists and found to be a schwannoma. The patient had normal vagus sensory and motor function postoperatively, with a slight Horner syndrome. Discussion: nerve tumors of the neck arise from large nerve trunks, the IX, X, XI, and XII cranial nerves, the cervical sympathetic, the cervical plexus, and the brachial plexus. The vagus nerve is an infrequent place of appearance with very few reported cases. They are difficult preoperative diagnosis lesions; whose treatment of choice is surgical excision; sometimes it is difficult to preserve the nerve of origin.

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          Most cited references9

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          Schwannomas in the head and neck: retrospective analysis of 21 patients and review of the literature

          CONTEXT AND OBJECTIVE: Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. According to their cellularity, they can be subdivided into Antoni A or Antoni B types. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25% of the cases, and may be associated with Von Recklinghausen's disease. The present study retrospectively analyzed some data on this disease in the head and neck region and reviewed the literature on the subject. DESIGN AND SETTING: Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. METHODS: Data on 21 patients between 1980 and 2003 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and association with neurofibromatosis were evaluated. RESULTS: The patients' ages ranged from 16 to 72 years. Four patients had a positive past history of type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial and cervical plexuses, vagus nerve, sympathetic chain and lingual or recurrent laryngeal nerve. The nerve of origin was not identified in six cases. Tumor enucleation was performed in 16 patients; the other five required more extensive surgery. CONCLUSION: Schwannomas and neurofibromas both derive from Schwann cells, but are different entities. They are solitary lesions, except in Von Recklinghausen's disease. They are generally benign, and rarely recur. The recommended surgical treatment is tumor enucleation.
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            An extensive cervical vagal nerve schwannoma: a case report.

            Vagal nerve schwannoma is extremely rare. The majority of cases present with a slow growing neck swelling without neurological deficit. Magnetic resonance imaging is the gold standard investigation to establish a pre-operative diagnosis. We report a case of a 32-year-old man with an extensive right vagal nerve schwannoma involving the right jugular foramen and parapharyngeal space. The tumour was resected via a transcervical approach. Complete excision of the tumour is the key to prevent recurrence.
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              Schwanomas cervicales

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                Author and article information

                Journal
                angiologia
                Angiología
                Angiología
                Arán Ediciones S.L. (Madrid, Madrid, Spain )
                0003-3170
                1695-2987
                June 2021
                : 73
                : 3
                : 144-147
                Affiliations
                [1] Pontevedra orgnameComplejo Hospitalario Universitario de Pontevedra orgdiv1Servicio de Angiología, Cirugía Vascular y Endovascular Spain
                Article
                S0003-31702021000300006 S0003-3170(21)07300300006
                10.20960/angiologia.00182
                746b06f6-bdb6-44a4-9cf7-2674e6509c92

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 25 June 2020
                : 13 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                Cervical,Vagus-nerve,Schwannoma,Nervio vago
                Cervical, Vagus-nerve, Schwannoma, Nervio vago

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