Ancient Schwannoma: Cervical Sympathetic Chain with Review of Literature

Schwannoma in cervical region arising from Sympathetic chain is a very rare entity. Ancient schwannoma is the term used to describe a schwannoma that has undergone changes viz loss of antoni Type A cells, perivascular hyalinization, calcification, cystic necrosis, hemorrhage and presence of degenerative nuclear changes. Ackerman and Taylor (Cancer 4:669-691, 1951) introduced the term "ancient schwannoma". Badawi (Eur J Surg Oncol 28(1):88-90, 2002) in 2002 reported the first case of ancient schwannoma of the sympathetic chain. Surgery is the choice of treatment. In most of the cases Horner's syndrome may or may not be the presenting symptom but may appear postoperatively. First bite syndrome is another complication of surgery. These must be kept in mind and proper counseling should be done preoperatively. Fine needle aspiration cytology (FNAC) may be misleading. To diagnose, radiological investigations like CT/MRI are helpful. They may mimic carotid body tumor, vagal schwannoma, necrotic lymph node and sarcoma.