Cervical sympathetic chain schwannomas masquerading as carotid body tumors

Cervical sympathetic chain (CSC) schwannoma is a rare neurogenic tumor that can mimic a carotid body tumor (CBT). Two male patients aged 33 and 49 yea rs old were referred for a cervical mass thought to be a CBT. Both patients were found to have an asymptomatic, pulsatile, nontender mass located at t he level of the angle of the mandible. Both patients were neurologically as ymptomatic and cranial nerves were normal. Both patients underwent neck exp loration and resection of the mass involving the CSC. Postoperatively, a Ho rner's syndrome was present. Histopathology confirmed both tumors to be sch wannomas of the CSC. At follow-up, both patients are asymptomatic with no r ecurrence. The main imaging criterion to differentiate a CBT from a CSC sch wannoma is the lack of hypervascularity of the latter. Malignant transforma tion is extremely rare. Tumor excision gives excellent results with no loca l recurrence. Horner's syndrome is an expected postoperative complication.