Primary thyroid schwannoma masquerading as a thyroid nodule

Dhar, Harsh; Dabholkar, Jyoti; Kandalkar, Bhuvaneshwari; Ghodke, Ratnaprabha

doi:10.1093/jscr/rju094

Cited by 14 publications

(18 citation statements)

References 6 publications

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“…Intrathyroidal schwannomas have been reported globally and most occur in the 40- to 60-year-old age group [1]. Unlike most reported cases of thyroid schwannomas whose FNA findings were often inconclusive [1,3,4,8], our preoperative FNA yielded spindle-shaped cells. The differential diagnosis of spindle cell lesions includes neural derived tumors, mesenchymal lesions (leiomyoma, solitary fibrous tumor, hemangiopericytoma), epithelial tumors (anaplastic thyroid cancer - particularly if the tumor cells undergo degeneration), medullary thyroid cancer, thymoma, spindle epithelial tumor with thymus-like differentiation (SETTLE), and hyalinizing trabecular adenoma.…”

Section: Discussionmentioning

confidence: 75%

“…These peripheral nerve growth tumors occur in the extremities as well as the head and neck [1]. Head and neck schwannomas can mimic thyroid nodules whether they present as cervical or (rarely) intrathyroidal lesions [2,3,4]. Presurgical diagnosis can be challenging as these lesions are often mistaken for thyroid nodules [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Head and neck schwannomas can mimic thyroid nodules whether they present as cervical or (rarely) intrathyroidal lesions [2,3,4]. Presurgical diagnosis can be challenging as these lesions are often mistaken for thyroid nodules [1,4]. Here we present a case in which magnetic resonance imaging (MRI) and the unique characteristics of schwannomas on MRI facilitated the correct presurgical diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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A Cervical Schwannoma Masquerading as a Thyroid Nodule

et al. 2017

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Background: We present a case of a cervical schwannoma, likely originating from the pharyngeal plexus of the vagal nerve. The lesion masqueraded as a thyroid nodule and magnetic resonance imaging (MRI) assisted in preoperative diagnosis. We review the radiographic characteristics of nerve sheath tumors on MRI as well as the diagnostic cytologic stains which can enhance the possibility of a correct preoperative diagnosis. Case: We describe a 60-year-old female with dysphagia and a neck mass consistent with a nodular goiter. The patient's history, diagnostic images, cytology, pathology, and surgical management are presented and analyzed. The preoperative diagnosis of a cervical schwannoma was suspected by the use of MRI which led to additional specialized cytologic stains. Conclusion: Pharyngeal wall schwannomas are important to consider in the differential diagnosis of thyroid nodules when fine needle aspiration cytology indicates cells of neural origin. Imaging by MRI can assist in identifying lesions of neural origin masquerading as thyroid nodules.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Cervical Schwannoma Masquerading as a Thyroid Nodule

et al. 2017

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“…It was first described by Verocay in 1908, and the first reported case was by Delaney and Fry in 1964. 1 About 25-40% of cases occur in the head and neck region. 2 In the head and neck region, schwannomas arise most commonly from the vagus nerve or the sympathetic chain.…”

Section: Introductionmentioning

confidence: 99%

Schwannoma neck: a diagnostic dilemma

Manohar

Abdurahiman

2019

Int J Otorhinolaryngol Head Neck Surg

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<p>Schwannomas are less common benign slow growing tumors originating from Schwann cells. In the head and neck region, schwannomas arise most commonly from the vagus nerve or the sympathetic chain. We present this case as the location of schwannoma is extremely rare and due to the diagnostic difficulties it posed. A 48 year old male presented with right neck swelling and breathing difficulty to our OPD. Patient underwent ultrasonogram of neck, MRI neck and Fine needle aspiration cytology (FNAC) of the lesion. Each of the investigations suggested different pathology which made the diagnosis challenging. During surgery, the lesion was found to arise from right recurrent laryngeal nerve. After excision of the lesion, the patient developed hoarse voice and the pathological examination revealed schwannoma. Schwannomas that originate from Schwann cells can affect any part of the body. MRI, CT, USG and FNAC have been suggested in the literature for diagnosing the lesion. Trucut biopsy should be considered in situations where FNAC becomes inconclusive. Surgical excision is the treatment of choice. Histologically, five variants of schwannomas have been described in the literature namely common, plexiform, cellular, epithelioid and ancient schwannoma. To conclude, schwannoma arising from RLN which masqueraded as a thyroid swelling is a rare entity. The diagnostic modalities suggested in the literature were unable to pin point the diagnosis. Once, FNAC shows an inadequate specimen, a trucut biopsy should be considered as the next investigation modality.</p>

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“…The main sources were sympathetic nerve (26.9%), brachial plexus (23.6%), vagus nerve (21.8%), cervical plexus (9.8%) and hypoglossal nerve (3.6%) [2]. Schwannomas of the head and neck may present as nodules of the thyroid, regardless of the presence of cervical or (rarely) intrathyroid lesions [3] [4] [5]. The occurrence of thyroid is extremely rare, and there are few reported cases.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Diagnosis of Cervical Vagal Schwannoma Misdiagnosed as Nodular Goiter

Man¹,

Chau²

2018

OJRad

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Background: Schwannoma is a benign tumor derived from Schwann cells. The most common location was cerebellopontine angle (CPA). Neurilemmoma originated from the thyroid gland is very rare. Purpose: To discuss the diagnosis and treatment of cervical vagal schwannoma and the causes of misdiagnosis and preventive measures. Case Presentation: A case of cervical vagal schwannoma misdiagnosed as nodular goiter by ultrasonography was analyzed retrospectively. This patient was found to have pain in the neck for 1 month and then went to our hospital for treatment. After admission, a 5 cm × 4 cm mass was found on the left side of the neck, with a medium texture and clear margin. It could move with swallowing. Initially ultrasound showed a well circumscribed hypoechoic mass in the left thyroid lobe, which is suggestive of hemorrhage of thyroid nodule. Biopsy of thyroid nodules after ultrasound guided biopsy revealed Schwannoma. Surgical treatment and postoperative pathological examination confirmed cervical vagal schwannoma. The patient recovered well and was discharged 9 days after operation. Conclusion: The location of thyroid schwannoma is rare, the relationship between thyroid schwannoma and surrounding tissues is unclear, and there is no typical ultrasonic manifestation. Moreover, if doctors are not aware of their knowledge, it is easy to cause misdiagnosis. Radiologists should raise awareness of the disease and carefully analyze the results of ultrasonography in combination with the clinical manifestations of the patients so as to reduce or avoid misdiagnosis of cervical schwannoma.

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Primary thyroid schwannoma masquerading as a thyroid nodule

Cited by 14 publications

References 6 publications

A Cervical Schwannoma Masquerading as a Thyroid Nodule

A Cervical Schwannoma Masquerading as a Thyroid Nodule

Schwannoma neck: a diagnostic dilemma

Ultrasound Diagnosis of Cervical Vagal Schwannoma Misdiagnosed as Nodular Goiter

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