Source: International Journal of Research in Medical Sciences
Shaheen H. Kanpurwala, Nisha V. Thakare, Prashant S. Mane.
Intraparotid facial nerve schwannoma was first reported by Ibarz in 1927. The frequency of intra-parotid schwannomas range from 0.2% to 1.5%. Facial nerve schwannoma can occur at any point along its course from the cerebello-pontine angle to its peripheral branches. Its typical presentation is a slow growing, painless mass mimicking a pleomorphic adenoma. Because of its low prevalence and very few clinical and radiological signs associated with it, pre-operative diagnosis of intraparotid facial nerve schwannoma is generally difficult. There is great potential of misdiagnosis and mismanagement when detected intra-operatively with the worst consequences of facial nerve palsy. In this case a 58 years old male had a parotid mass with a prolonged history of sixteen years with sudden increase in size. Preoperative work up of imaging modalities and fine needle aspiration cytology was not conclusive. Intraoperatively mass couldnt be separated from the facial nerve, so total parotidectomy for the tumor with transection of facial nerve was done resulting in postoperative facial nerve paralysis. The diagnosis of schwannoma was offered only after histopathological examination. Parotid nerve schwannomas are extremely rare and routine investigations are not very helpful in diagnosis. Whenever a facial nerve is seen involved by a clinically benign appearing lesion, intraparotid schwannoma should be thought of as a diagnostic possibility to avoid radical surgery and prevent complications like facial nerve palsy.
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