A unique and challenging case of ancient schwannoma in the parapharyngeal space

Schwannoma (neurilemmoma) is an encapsulated, benign tumour that arises from nerve sheath cells. Among its histological subtypes, ancient schwannoma is the most uncommon. In 1951, Ackerman and Taylor described it for the first time. Here, we describe a 25-year-old male patient who had diffuse neck swelling for 4-month duration. Magnetic resonance imaging showed an encapsulated, heterogeneously enhancing lesion in the right parapharyngeal space with a few cystic areas. Tumour excision was done, determined to be the ancient variant of schwannoma with histopathology. A case of ancient schwannoma arising in the parapharynx is uncommon, and it presents ambiguously, making pre-operative diagnosis challenging.