OJST  Vol.4 No.8 , August 2014
Schwannoma of Hypoglossal Nerve Origin in the Upper Neck: Case Report and Review of the Literature
Abstract: Schwannomas originating from the hypoglossal nerve are extremely rare neoplasms. Hypoglossal schwannomas usually occur between the third and fifth decades of life, with no sex predilection, commonly presenting as a painless, slow-growing, and lateral neck mass. The best treatment is complete surgical excision with preservation of the neural pathway, if possible. In fact, since these tumors are almost always benign, a conservative surgical approach is emphasized by most authors. We report a case of a large schwannoma of hypoglossal nerve origin in the upper neck in a 31-year-old male. Magnetic resonance imaging of the area demonstrated a 43 × 39 × 36 mm well-circumscribed mass with high and nonhomogeneous signal intensity on the right side of the upper neck. The lesion was successfully treated by extirpation, with no recurrence. The extracranial hypoglossal nerve sheath was as the origin of this tumor because the patient experienced remarkable disturbance of tongue motility after surgery.
Cite this paper: Morita, Y. , Kawakita, C. , Taya, M. , Yuzaki, K. , Kotani, T. , Iwagami, T. , Kobayashi, K. and Morita, N. (2014) Schwannoma of Hypoglossal Nerve Origin in the Upper Neck: Case Report and Review of the Literature. Open Journal of Stomatology, 4, 418-423. doi: 10.4236/ojst.2014.48056.

[1]   Rachinger, J., Fellner, F.A. and Trenkler, J. (2003) Dumbbell-Shaped Hypoglossal Schwannoma. A Case Report. Magnetic Resonance Imaging, 21, 155-158.

[2]   Ho, K.L. (1981) Schwannoma of the Trochlear Nerve. Case Report. Journal of Neurosurgery, 55, 132-135.

[3]   Hoshi, M., Yoshida, K., Ogawa, K. and Kawase, T. (2000) Hypoglossal Neurinoma—Two Case Reports. Neurologia Medico-Chirurgica (Tokyo), 40, 489-493.

[4]   Chang, S.C. and Schi, Y.M. (1984) Neurilemmoma of the Vagus Nerve. A Case Report and Brief Literature Review. Laryngoscope, 94, 946-949.

[5]   Diaz, D.D., Kennedy, K.S., Parker, G.S. and White, V.J. (1991) Schwannoma of the Submandibular Gland. Head & Neck, 13, 239-242.

[6]   Drevelengas, A., Kalaitzoglou, I. and Lazaridis, N. (1998) Sublingual Hypoglossal Neurilemmoma. Case Report. Australian Dental Journal, 43, 311-314.

[7]   Chang, K.-C. and Leu, Y.-S. (2002) Hypoglossal Schwannoma in the Submandibular Space. Journal of Laryngology Otology, 116, 63-64.

[8]   Kawakami, R., Kaneko, T., Kadoya, M., Matsushita, T., Fujinaga, Y., Oguchi, K. and Kurashina, K. (2004) Schwannoma in the Sublingual Space. Dentomaxillofacial Radiology, 33, 259-261.

[9]   Yasumatsu, R., Nakashima, T., Miyazaki, R., Segawa, Y. and Komune, S. (2013) Diagnosis and Management of Extracranial Head and Neckschwannomas: A Review of 27 Cases. International Journal of Otolaryngology, 2013, Article ID: 973045.

[10]   De Araujo, C.E.N., Ramos, D.M., Moyses, R.A., Durazzo, M.D., Cernea, C.R. and Ferraz, A.R. (2008) Neck Nerve Trunks Schwannomas: Clinical Features and Postoperative Neurologic Outcome. Laryngoscope, 118, 1579-1582.

[11]   Biswas, D., Marnane, C.N., Mal, R. and Baldwin, D. (2007) Extracranial Head and Neck Schwannomas—A 10-Year Review. Auris Nasus Larynx, 34, 353-359.

[12]   Nonaka, Y., Grossi, P.M., Bulsara, K.R., Taniguchi, R.M., Friedman, A.H. and Fukushima, T. (2011) Microsurgical Management of Hypoglossal Schwannomas over 3 Decades: A Modified Grading Scale to Guide Surgical Approach. Neurosurgery, 69, 121-140.

[13]   Jia, G., Wang, Z. and Zhang, J. (2001) Diagnosis and Treatment of Hypoglossal Neurinoma. Chinese Medical Journal, 81, 1264-1265.

[14]   Okura, A., Shigemori, M., Abe, T., Yamashita, M., Kojima, K. and Noguchi, S. (1994) Hemiatrophy of the Tongue Due to Hypoglossal Schwannoma Shown by MRI. Neuroradiology, 36, 239-240.

[15]   Bartal, A.D., Djaldetti, M.M., Mandel, E.M. and Lerner, M.A. (1973) Dumb-Bell Neurinoma of the Hypoglossal Nerve. Journal of Neurology, Neurosurgery Psychiatry, 36, 592-595.

[16]   Sutay, S., Tekinsoy, B., Ceryan, K. and Aksu, Y. (1993) Submaxillary Hypoglossal Neurilemmoma. The Journal of Laryngology & Otology, 107, 953-954.

[17]   Colreavy, M., Lacy, P., Hughes, J., Bouchier-Hayes, D., Brennan, P., O’Dwyer, A.J., Donnelly, M.J., Gaffney, R., Maguire, A., O’Dwyer, T.P., Timon, C.V. and Walsh, M.A. (2000) Head and Neck Schwannomas—A 10 Year Review. The Journal of Laryngology & Otology, 114, 119-124.

[18]   Chiofalo, M.G., Longo, F., Marone, U., Franco, R., Petrillo, A. and Pezzullo, L. (2009) Cervical Vagal Schwannoma. A Case Report. Acta Otorhinolaryngologica Italica, 29, 33-35.

[19]   Lee, M.K., Sidell, D.R., Mendelsohn, A.H. and Blackwell, K.E. (2012) Hypoglossal Schwannoma Masquerading as a Carotid Body Tumor. Case Reports in Otolaryngology, 2012, Article ID: 842761.

[20]   De Foer, B., Hermans, R., Sciot, R., Fossion, E. and Baert, A.L. (1995) Hypoglossal Schwannoma. Annals of Otology, Rhinology & Laryngology, 104, 490-492.

[21]   Piccirilli, M., Anichini, G., Fabiani, F. and Rocchi, G. (2007) Neurinoma of the Hypoglossal Nerve in the Submandibular Space: Case Report and Review of the Literature. Acta Neurochirurgica, 149, 949-952.