A Case of Schwannoma of the Recurrent Laryngeal Nerve Associated with Vocal Cord Palsy after Fine-Needle Aspiration

Jeong Won Lee; Young Kim; Hee Kyung Kim; Ho-Cheol Kang

doi:10.11106/jkta.2014.7.1.92

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Lee, Kim, Kim, and Kang: A Case of Schwannoma of the Recurrent Laryngeal Nerve Associated with Vocal Cord Palsy after Fine-Needle Aspiration

Case Report

J Korean Thyroid Assoc 2014;7(1):92-95.

Published online: 29 May 2014

DOI: https://doi.org/10.11106/jkta.2014.7.1.92

A Case of Schwannoma of the Recurrent Laryngeal Nerve Associated with Vocal Cord Palsy after Fine-Needle Aspiration

Jeong Won Lee¹, Young Kim², Hee Kyung Kim¹, Ho-Cheol Kang¹

¹Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

²Department of Pathology, Chonnam National University Medical School, Gwangju, Korea

Correspondence: Hee Kyung Kim, MD, Department of Internal Medicine, Chonnam National University Medical School, Hak-dong 5, Dong-ku, Gwangju 501-746, Korea Tel: 82-61-379-7621, Fax: 82-61-379-7628, E-mail: albeppy@gmail.com

Received 20 August 2013 Accepted 25 November 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Approximately 25-45% of all schwannomas occur in the head and neck, and lesions originating from the recurrent laryngeal nerve are very rare. When a tumor is located in the neck, it is difficult to differentiate schwannoma from other lesions including thyroid, parathyroid, or esophageal masses; or lymphoma. We report here a case of schwannoma of the recurrent laryngeal nerve, confused with a thyroid mass, in a 67-year-old woman. Our patient complained of hoarseness after fine-needle aspiration of the mass. It was diagnosed as vocal cord palsy and she underwent surgery for mass removal. Pathological examination showed that the mass was an ancient schwannoma. The case suggests that clinicians should note that schwannoma of the recurrent laryngeal nerve may present as a thyroid mass, and hoarseness is one possible complication developing after fine-needle aspiration or surgery.

Keywords: Schwannoma, Recurrent laryngeal nerve, Hoarseness, Fine-needle aspiration

References

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Fig. 1.

Imaging studies. (A) A thyroid ultrasound scan revealed a well-defined hypoechoic mass 3.1 × 2.6 × 7.5 cm in dimensions adjacent to the left thyroid gland. (B) Neck CT showed a well–defined heterogeneously enhanced mass (black arrow) 3.6 × 2.9 × 8.3 cm in dimensions extending into the mediastinum.

Fig. 2.

The resected specimen features a yellowish tumor with the consistency of firm rubber (white arrow) and the left thyroid gland (black arrow), of dimensions 3.0 × 2.5 × 9.0 cm and 4.0 × 3.0 × 1.5 cm, respectively. The mass was adherent to the left recurrent laryngeal nerve.

Fig. 3.

Microscopic findings. (A) Histologically, the tumor contained spindle-shaped cells with elongated nuclei (H&E stain, × 200). An Antoni A area exhibiting hypercellularity was evident. (B) The tumor cells were immunoreactive for the S–100 protein (H&E stain, X 200).

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