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Updated: Jun 15, 2026

Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Horner syndrome associated with contusion of the longus colli muscle simulating a tumor
Mohannad Ibrahim1, Hemant Parmar, Lynda Yang
1Department of Radiology (Neuroradiology), University of Michigan Medical System, Ann Arbor, Michigan 48109, USA. mibrahim@umich.edu
Abstract:
A 22-year-old man who was discovered unarousable after an accidental methadone overdose complained of worsening neck pain and left arm weakness over the next week. Examination disclosed a left Horner syndrome and a left brachial plexopathy. Imaging showed a left paraspinal mass adjacent to the sympathetic pathway at the fourth and fifth cervical vertebral levels with imaging features of a tumor. Biopsy was deferred. One month later, the imaging abnormality had nearly disappeared. In retrospect, it represented a contusion injury of the longus colli muscle, a finding not reported previously. Whether it caused the Horner syndrome or was merely a bystander in cervical neck trauma is uncertain. This abnormality should be recognized as a diagnostic confounder.
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