Ancient schwannoma of the facial nerve: a case report

Ancient schwannomas are rare benign tumours, deriving from neural crest cells. Schwannomas of the head and neck are frequently misdiagnosed and preoperative investigations are often fruitless. We report a very rare case of a patient with a schwannoma of the seventh nerve. T.A., a 43-year-old male, was referred to our department in September 2003 with a 6-month history of a gradually enlarging asymptomatic right neck mass. Ultrasonography of the parotid gland demonstrated the presence of a nodule, with irregular borders, measuring about 2.90 x 2.00 x 1.70 cm. During surgery we found a mass apparently spreading from the parotid gland and therefore we decided to resect the mass together with the gland. The histological examination yielded a diagnosis of ancient schwannoma. Schwannomas are very rare and approximately 25-30% of all reported cases occur in the head and neck, mostly in the eighth nerve, while involvement of the seventh nerve is extremely rare.