Ann Rehabil Med.  2017 Dec;41(6):1100-1104. 10.5535/arm.2017.41.6.1100.

Collet-Sicard Syndrome With Hypoglossal Nerve Schwannoma: A Case Report

• Lee SH
• Lee ES
• Yoon CH
• Shin H
• Lee CH

• KMID: 2400297
• DOI: http://doi.org/10.5535/arm.2017.41.6.1100

Abstract

Collet-Sicard syndrome is a rare syndrome that involves paralysis of 9th to 12th cranial nerves. We report an uncommon case of schwannoma of the hypoglossal nerve in a 39-year-old woman presented with slurred speech, hoarse voice, and swallowing difficulty. Physical examination revealed decreased gag reflex on the right side, decreased laryngeal elevation, tongue deviation to the right side, and weakness of right trapezius muscle. MRI revealed a mass lesion in the right parapharyngeal space below the jugular foramen. The tumor was surgically removed. It was confirmed as hypoglossal nerve schwannoma via pathologic examination. Videofluoroscopic swallowing study revealed aspiration of liquid food and severe bolus retention in the vallecula and piriform sinus. Laryngoscopy revealed right vocal cord palsy. Electrodiagnostic study revealed paralysis of the right 11th cranial nerve. In summary, we report an uncommon case of schwannoma of the hypoglossal nerve with 9th to 12th cranial nerve palsy presenting as Collet-Sicard syndrome.

Keyword

Collet-Sicard Syndrome; Hypoglossal nerve; Schwannoma

MeSH Terms

Adult
Cranial Nerve Diseases
Cranial Nerves
Deglutition
Female
Humans
Hypoglossal Nerve*
Laryngoscopy
Magnetic Resonance Imaging
Neurilemmoma*
Paralysis
Physical Examination
Pyriform Sinus
Reflex
Superficial Back Muscles
Tongue
Vocal Cord Paralysis
Voice

Figure

• 

  Fig. 1 Magnetic resonance image revealed a well-demarcated ovoid heterogeneous mass lesion (white arrow) in the right parapharyngeal space below the jugular foramen, measuring 2.2 cm.

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  Fig. 2 The tongue deviates to the right side on protrusion (white arrow), indicating right hypoglossal nerve palsy.

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  Fig. 3 Vocal cord palsy. When the patient vocalizes, only the left side of the vocal cord moves normally. The right side of the vocal cord does not move (white arrow), indicating right vagus nerve palsy.

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  Fig. 4 Videofluoroscopic swallowing study (VFSS) shows tracheal aspiration (A) and severe bolus retention (B) in the vallecula and piriform sinus. Follow-up VFSS shows mild bolus retention (C) in the vallecula and piriform sinus.

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