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Two-for-one neck masses: a case of multiple schwannomas

Published:September 02, 2022DOI:https://doi.org/10.1016/j.amjmed.2022.08.021
      A 42-year-old female was seen due to a left-sided neck mass for several months. Her medical history was unremarkable outside of left-sided adhesive capsulitis diagnosed 2 years ago. Physical exam showed a 4 cm level II neck mass with left cranial nerve XI (CN XI) weakness. Flexible laryngoscopy revealed normal true vocal cords. Both CT and MRI showed a well-defined mass deep to the left sternocleidomastoid at the level of the mandibular angle causing mass effect and stenosis of the left internal jugular vein. Another smaller mass was incidentally noted supero-medially to the dominant mass and just lateral to the internal carotid artery at the skull base (Figure 1, Figure 2).
      Figure 1
      Figure 1Well-circumscribed, cystic and solid enhancing dominant mass
      Figure 2
      Figure 2Smaller mass superior and medial to the dominant mass

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