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Neck schwannoma diagnosed by core needle biopsy: a case report

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Abstract

Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.

Riassunto

Presentiamo il caso di un uomo di 58 anni che si sottoponeva ad ecotomografia del collo per una massa palpabile in sede laterocervicale destra. L’esame ecotomografico ha mostrato la presenza di una lesione solida nella regione laterocervicale destra del collo, con caratteristiche ecografiche sospette per linfonodo neoplastico. Contestualmente, si riscontrava un nodulo solido ipoecogeno del lobo destro della tiroide. Allo scopo di un’ulteriore definizione diagnostica, si è pertanto deciso di procedere ad esecuzione di agoaspirato ecoguidato di entrambe le lesioni, inviando per esame citologico il materiale ottenuto. Il nodulo tiroideo ha mostrato caratteri di benignità, mentre il prelievo eseguito sulla formazione del collo non è apparso adeguato per la valutazione citologica. Abbiamo così deciso di procedere a core needle biopsy della lesione del collo, eseguendo la medesima procedura anche sul nodulo tiroideo, per una conferma diagnostica. L’esame istologico ha confermato la benignità del nodulo tiroideo e la lesione del collo è risultata una proliferazione di tipo neuronale compatibile con schwannoma. Il paziente è stato quindi indirizzato a follow-up clinico ed ecografico. In conclusione, nel caso clinico da noi presentato la core needle biopsy è apparsa una procedura sicura e mini-invasiva nell’inquadramento diagnostico di una massa del collo di incerto significato all’esame ecotomografico, senza necessità di ulteriori approcci chirurgici.

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Conflict of interest

All the authors—Nasrollah N, Trimboli P, Bianchi D, Taccogna S—declare that they have no conflict of interests.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Section of Surgery, Ospedale Israelitico, Via Fulda, 14, 00148, Rome, Italy

    N. Nasrollah

  2. Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy

    P. Trimboli

  3. Section of Surgery, Policlinico Tor Vergata, Rome, Italy

    D. Bianchi

  4. Section of Pathology, Ospedale Israelitico, Rome, Italy

    S. Taccogna

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  1. N. Nasrollah
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  2. P. Trimboli
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  3. D. Bianchi
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  4. S. Taccogna
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Corresponding author

Correspondence to N. Nasrollah.

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Nasrollah, N., Trimboli, P., Bianchi, D. et al. Neck schwannoma diagnosed by core needle biopsy: a case report. J Ultrasound 18, 407–410 (2015). https://doi.org/10.1007/s40477-014-0112-7

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  • DOI: https://doi.org/10.1007/s40477-014-0112-7

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