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Case Reports
. 2021 Aug 20;15(1):436.
doi: 10.1186/s13256-021-03006-x.

Multiple schwannomas of the facial nerve mimicking cervical lymphoma: a case report

Jan Philipp Kühn  1 , Mathias Wagner  2 , Alessandro Bozzato  3 , Maximilian Linxweiler  3
Affiliations
Case Reports

Multiple schwannomas of the facial nerve mimicking cervical lymphoma: a case report

Jan Philipp Kühn et al. J Med Case Rep. .

Abstract

Background: In this report, we describe the first case in literature of a patient with multiple schwannomas of the marginal mandibular branch of the facial nerve.

Case presentation: A Caucasian patient presented with a sudden onset of left lower facial nerve palsy House-Brackmann score III for 1 month. Computed tomography imaging was performed to exclude a cerebral event and revealed multiple tumors within the left parotid gland. Duplex ultrasound and magnetic resonance imaging scans delineated multiple, hypoechoic tumors, round in shape and well defined without a hilar structure along the left mandible. For histological verification, a left-side partial parotidectomy and extirpation of an intraparotideal node was performed with use of a nerve-integrity monitor. Histomorphological analysis of the resected tissue revealed a benign schwannoma. Facial nerve function remained unchanged since the operation. The size of the nonresected tumors is currently monitored regularly by ultrasonography. Fibromatosis has been excluded.

Conclusions: If multiple tumors occur in the parotid gland and the angle of the jaw, schwannomas need to be considered as a differential diagnosis. To plan the right diagnostic surgical intervention and prevent nerve damage, a thorough ultrasound examination is essential in preoperative diagnostic work-up for any suspicious lesion of the parotid gland and jaw region.

Keywords: Cervical lymphoma; Facial nerve; Multiple schwannomas; Parotid gland.

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Conflict of interest statement

None to declare.

Figures

Fig. 1
Fig. 1
A Ultrasonography. Multiple round-shaped, homogeneous and smooth structures along the course of the left marginal mandibular branch of the facial nerve. B Cranial magnetic resonance imaging T1 coronal view. Multiple tumors in the left parotid gland along the facial nerve. A & B: Arrow is showing the tumors
Fig. 2
Fig. 2
A Anti-S100 immunohistochemical staining with strong intralesional signals in nearly all cells. B Anti-Mib1 immunohistochemical staining showing several “hot spots” in the tumor tissue
See this image and copyright information in PMC

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