Intraparotid facial nerve schwannoma: A case report

Intraparotid facial nerve schwannoma is a rare tumor accounting for only 0.2 - 1.5 % of all parotid tumors. We present this case because this tumor grows slowly and rarely produces signs and symptoms thus mimicking pleomorphic adenoma which is much more common. It should therefore be considered in the differential diagnoses of slowly enlarging parotid swellings. When it is diagnosed peroperatively the management differs significantly and is a matter of debate with few favoring complete excision whereas others favoring a more conservative approach avoiding resection and going only with biopsy for histological confirmation. We have discussed the various indications for operative management of the facial nerve schwannoma and stressed the importance of the size of the tumor and the patients preference for operation. We report a case of a middle aged male with a parotid swelling. The patient was investigated and a diagnosis of pleomorphic adenoma was made. The patient was operated and peroperatively the frozen section biopsy revealed a facial nerve schwannoma. Facial nerve schwannoma though rare should be also considered in the differential diagnoses of the parotid swelling because most of the time diagnosis is made preoperatively and then the surgeon finds himself in dilemma as to the best plan of management since it is still a matter of debate. We have discussed the various indications for operative management of the facial nerve schwannoma and stressed the importance of the size of the tumor and the patients preference for operation.