Abnormal growth rate of a benign cervical sympathetic chain schwannoma

Background: Schwannomas are rare benign tumors that arise from the Schwann cells of the nerve sheath. Schwannomas are characteristically indolent, growing approximately 1–3 mm a year. We report a case of cervical sympathetic chain schwannoma (CSCS) with a rapid rate of growth while being regularly imaged for another disease process. Methods: A 57-year-old female with a history of papillary thyroid cancer (PTC) presented with a left level IV neck mass discovered on a routine ultrasound. The mass was not visualized on her most recent ultrasound 11 months prior. Results: The patient underwent extracapsular enucleation of the schwannoma, which arose from the cervical sympathetic chain. Final pathology confirmed the diagnosis of a benign schwannoma. Conclusions: This case serves as a reminder that not all benign CSCSs are indolent and also highlights the fact that the rapid rate of growth of these lesions is not necessarily indicative of a malignant transformation.