VAGAL SCHWANNOMA MASQUERADING AS THYROID NODULE

Head and Neck Schwannomas are rare. Cervical vagal schwannoma constitutes about 2-5% of neurogenic tumours. Vagal Schwannoma may masquerade as thyroid nodule. A 76-year-old male presented with hoarseness and gradually increasing swelling in the left side of the neck for 30 years. Presence of a neck mass on left side with Substernal extension, xity and left vocal cord palsy was suspicious for thyroid malignancy. Ultrasonography (USG) Neck was suggestive of left Thyroid Nodule 7 x 5cm. Fine needle aspiration cytology (FNAC) reports were suggestive of Colloid goitre. Contrast enhanced CT (CECT) Neck ndings shows hypo-intense mass splaying the carotid artery and Internal Jugular Vein (IJV). Subsequent FNAC reports were suggestive of spindle cell tumour (Sternocleidomastoid Tumour). Intra-operatively, tumour was arising from left vagus nerve, excised and histopathological examination (HPE) conrmed Vagal Schwannoma. FNAC may yield erroneous report if the aspirate is from thyroid tissue adjacent to the vagal schwannoma or may be confused with other spindle cell tumour like sternomastoid tumour in vagal schwannoma patients. USG and CECT neck may need in depth analysis to differentiate Vagal Schwannoma from thyroid malignancies.