Papillary Carcinoma with Vagus Schwanomma: A Rare Case Report and Literature Review

• RAJESH GOUD ERAPURAM,  
• MANIDEEP BILLA,*  
• HARSHINI CHINTAPENTA,  
• SRIHARSHA TALASILA,  
• VAISHNAVI KUNDARAM

Abstract

A schwannoma is a rare, slow growing, encapsulated nerve sheath tumour. Schwannomas originating from the vagus nerve are considered to be relatively uncommon, representing a minimal fraction of the total incidence of schwannomas and predominantly localized in the neck region. They are relatively difficult to diagnose, often mistaken for a swelling arising from the thyroid gland. In this case report, we described a patient who had a left side neck mass that was identified as thyroid papillary carcinoma with left vagal schwannoma. This case is about a 85 year old patient with a mass on their left side of the neck. The preliminary diagnostic measures encompass an ultrasound examination of the neck, followed by ultrasonography guided fine needle aspiration cytology of the lesion. A contrast enhanced computed tomography scan can also help in diagnosis, evaluate the extent of the tumour, and aid in planning surgical management. The patient was diagnosed with papillary carcinoma of the thyroid, accompanied by a left vagal schwannoma. When the findings from fine needle aspiration cytology suggest the presence of cells with neural origin, it becomes crucial to include schwannomas within the list of differential diagnoses for thyroid lesions. Imaging techniques such as ultrasound and contrast-enhanced computed tomography (CECT) can provide additional support in distinguishing lesions originating from the neurol origin, which may appear as thyroid lesions. The schwannoma can be treated by excision while exercising caution so as to not damage the vagus nerve and the papillary carcinoma of thyroid is managed with total thyroidectomy.

Keywords

Vagal Schwannoma, vagus nerve, papillary carcinoma, thyroidectomy