A 57-year-old male patient who presented with a massive paratracheal tumor was admitted for tumor extirpation. The presented tumor was exposed by a growth spurt in approximately 6 months’ time. This manifested in tracheoesophageal compression symptoms (tracheal deviation on roentgenography, significant dyspnea, and dysphagia). Surgical extirpation was recommended as a treatment of choice.
After positioning patient with rotated head on the contralateral side, a longitudinal incision was made on the anterior border of the sternocleidomastoid muscle extending from the clavicular head to the retromandibular area. The tumor was carefully dissected from structures present in the carotid sheath and fully extirpated in one piece from its bed, which extended proximally to the collar bone and cranially to the angle of the mandible. A histological examination of the extirpated tumor was performed.
After the paratracheal tumor was extirpated, an instant relief from the tracheoesophageal compression symptom was described by the patient. Final diagnosis was determined by a histological examination as an ancient schwannoma.
Currently, the only available treatment for this type of tumor is surgical extirpation. Histological examination is the only method that can establish final diagnosis.