Retropharyngeal Space Schwannoma: A Rare Entity

Document Type: Case Report

Authors

1 Department of Otorhinolaryngology, University of Insubria, Varese. ASST dei Sette Laghi, Ospedale di Circolo e Fondazione Macchi

2 Department of Otorhinolaryngology, Ospedale Giovanni Borea, Sanremo

Abstract

Introduction:
Retropharyngeal space schwannomas are rare entities. About 20-45% of schwannomas occur in the head and neck region; however, they represent less than 1% of all head and neck tumors.
 Case Report:
We present the case of a 36-year-old woman complaining of dysphagia caused by a large schwannoma arising in the posterior pharyngeal wall with remarkable reduction of the oropharyngeal space. The tumor was resected through a combined transoral and cervicotomic transmandibular approach due to its dimension. No recurrence was observed after a two-year follow up.  This case represents the thirteenth case reported in international literature.
 Conclusion:
Preoperative settings for rare tumors such as retropharyngeal schwannomas should include radiological investigations and preoperative biopsy. In order to obtain a successful result in terms of radicality, a combined surgical approach may be necessary to completely control the extension of the lesion.
 
 
 

Keywords

Main Subjects


1. Enzinger FM, Weiss SW. Benign tumors of peripheral nerves. In: Enzinger FM, Weiss SW, eds. Soft Tissue Tumors. 3rd ed. St Louis: Mosby, 1995:821-88.

2. Thurnher D, Quint C, Pammer J, Schima W, Knerer B, Denk, DM. Dysphagia due to a large schwannoma of the oropharynx: case report and review of the literature. Arch Otolaryngol Head Neck Surg 2002;128:850–2.

3. Kumagai M, Endo S, Shiba K, et al. Schwannoma of the retropharyngeal space. Tohoku J Exp Med 2006;210:161–4.

4. Saito DM, Glastonbury CM, El-Sayed IH, Eisele DW. Parapharyngeal space schwannomas: preopera- tive imaging determination of the nerve of origin. Arch Otolaryngol Head Neck Surg 2007; 133: 662–7.

5. Andre P, Laccoureye H. Tumeurs nerveuses parapharyngees. In: Leroux-Robert J, ed. Tumeurs Nerveuses ORL et Cervico-Faciales 51. Paris: Masson, 1977.

6. Triaridis C, Tsalighopoulos MG, Kouloulas A, Vartholomeos A. Posterior pharyngeal wall schwannoma (case report). J Laryngol Otol 1987; 101: 749-52.

7. Singh B, Ramjettan S, Maharaj TP, Ramsaroop R. Schwannoma of the posterior pharyngeal wall. J Laryngol Otol 1995;109:883-5.

8. Haraguchi H, Ohgaki T, Hentona H, Komatsuzaki A. Schwannoma of the posterior pharyngeal wall: a case report. J Laryngol Otol 1996;110:170-1.

9.  Moore CE, Putzi M, McClatchey KD, Terrell J. Ancient schwannoma of the posterolateral pharynx: a benign lesion commonly mistaken for sarcoma. Otolaryngol Head Neck Surg 1997;117:125-8.

10. Torre V, Bucolo S, Galletti B, et al. Benign extracranial cervical-facial schwannomas: anatomo-clinical and diagnostic considerations on our case reports and review of literature. Acta Otorhinolaryngol Ital 1999;19:160-5.

11. Thurnher D, Quint C, Pammer J, Schima W, Knerer B, Denk DM. Dysphagia due to a large schwannoma of the oropharynx: case report and review of the literature. Arch Otolaryngol Head Neck Surg 2002;128:850-2.

12. Huang CM, Leu YS. Schwannoma of the posterior pharyngeal wall. J Laryngol Otol 2002; 116:740-1.

13. Hsieh CY, Hsiao JK, Wang CP. Retropharyngeal schwannoma excised through a transoral approach: a case report. Kaohsiung J Med Sci 2006;22:465-9.

14. Kumagai M, Endo S, Shiba K, et al. Schwannoma of the retropharyngeal space. Tohoku J Exp Med 2006;210:161-4.

15. Jovanovic MB, Milutinovic Z, Milenkovic S. Posterior pharyngeal wall schwannoma - an unusual case. J Buon 2008;13:577–9.

16. Jovanovic MB, Milutinovic ZS, Strbac MS, Perovic JV, Milenkovic SA. Giant funicular intrapharyngeal schwannoma. Head Neck 2008; 30:1128-31.

17. Wax MK, Shiley SG, Robinson JL, Weissman JL. Cervical sympathetic chain schwannoma. Laryngoscope 2004;114:2210–3.

18. Work WP, Hybels RL. A study of tumors of the parapharyngeal space. Laryngoscope 1974; 84: 1748–55.

19. Kapadia SB. Tumors of the nervous system. In: Barnes L, ed. Surgical Pathology of the Head and Neck. 2nd ed. New York: Marcel Dekker Inc, 2000:795-8.