Photoclinic Diagnosis: Vagus Nerve Schwannoma

A32-year-old man was presented to the Department of Otolaryngology, Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran complaining of a left-sided neck lump since five months . The mass was located in the posterior part of the left submandibular region (Figure 1). There was no history of infections of upper respiratory tract, dental problems, or inflammations of oral cavity, oropharynx, salivary glands, nose, and paranasal sinuses. There was no pain, malaise, fever, or weight loss. He had no dysphagia, odynophagia, hoarseness, regurgitation, aspiration, or sense of pharyngeal numbness. On physical examination, there was a mass 4×4 cm in diameter involving level IB and superior level II of the neck. It was firm on palpation and mobile only in the anterior-posterior direction. The skin covering the lesion was normal and no sign of topical inflammation was present. Oral cavity, oropharynx, nose, nasopharynx, and larynx were normal. No other mass or lymphadenopathy was found in the neck.