PMC8407632_01
Multiple swellings of the anterior/posterior trunk and the left forearm of the patient
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F1
The patient had multiple swellings of his scalp, trunk, and left arm [Figure 1].
Left-sided huge swelling of the neck (note the tracheal shift to the right side due to mass effect)
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F2
Neck examination revealed a solitary symmetrical oval swelling of the left carotid triangle measuring approximately 15 cm x 8 cm with normal skin overlying and no visible scars [Figure 2].
Tongue deviation to the left (affected) side
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F3
Cranial nerve examination showed no abnormalities other than tongue deviation to the left side, which is consistent with left hypoglossal nerve involvement [Figure 3].
Coronal, axial, and sagittal magnetic resonance imaging demonstrating a large homogenous encapsulated mass in the left carotid space
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F4
Cervical MRI with contrast [Figure 4] highlighted a large prevertebral retroesophageal mass lesion measuring 13.7 cm x 6.4 cm x 4.1 cm in maximum craniocaudal, transverse, and anteroposterior dimensions, respectively, and displaying isointense signal on T1 and bright signal on T2 WIs with heterogeneous contrast uptake.
Coronal and sagittal magnetic resonance imaging of the brain showing multiple meningiomas and bilateral acoustic schwannomas
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F5
In addition, MRI of the brain [Figure 5] showed multiple meningiomas with bilateral acoustic schwannomas; findings were consistent with neurofibromatosis type II.
Intraoperative pictures of the mass and the excised patient's specimen
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F6
An ovoid well-circumscribed mass, with smooth yellow/tan outer surface showing prominent vascular arborization, was identified medial to the carotid sheath [Figure 6].
H and E-stained sections from the mass. Sections showing biphasic tumour formed of Antoni A areas (black arrows), with Verocay bodies (blue arrows), and Antoni B areas (white arrow)
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F7
Microscopic pictures [Figure 7] revealed a biphasic tumour formed of compact hypercellular (Antoni A) areas, with nuclear palisading around the fibrillary process (Verocay bodies), and myxoid hypocellular (Antoni B) areas.