Vagal Schwannoma Mimicking a Parotid Tumor: A Case Report

Vagal schwannoma is a rare benign tumor of the head and neck, originating from Schwann cells of peripheral nerves. These tumors are typically slow-growing and often present with nonspecific clinical features. The most common manifestation is a gradually enlarging neck mass; therefore, preoperative diagnosis is quite challenging, and such lesions are frequently misdiagnosed as parotid tumors, paragangliomas, or metastatic lymph nodes. We report the case of a 55-year-old male who presented with a right infra-auricular mass. The initial clinical evaluation suggested a parotid tumor; however, preoperative computed tomography revealed that the tumor was located posterior to the carotid space. After thorough discussion with the patient regarding surgical risks, including the possibility of postoperative vocal cord paralysis, the patient elected to proceed with surgical treatment. Intraoperatively, the tumor was identified as originating from the vagus nerve, and the diagnosis of schwannoma was confirmed by postoperative histopathological examination. The patient developed right vocal cord paralysis after surgery, and the symptoms gradually improved after voice rehabilitation therapy. This case demonstrates that for neck masses located in the infra-auricular or parotid region, vagal schwannoma should be included in the differential diagnosis. In addition, detailed preoperative counseling regarding potential complications, such as vocal cord paralysis, is essential for informed decision-making and optimal treatment planning.