Incidental intraparotid facial nerve schwannoma

Schwannomas are benign peripheral nerve sheath tumors. Although approximately one third of these lesions occur in the head and neck region; facial nerve schwannomas are rare, and most cases involve the intratemporal portion of the nerve. Herein, we report the case of an intraparotid facial nerve schwannoma which was an incidental finding on imaging studies. A 34‐year‐old woman presented with right neck fullness and was noted to have a palpable right neck mass inferior to her ear lobe. A CT scan was obtained and demonstrated an incidental, 1.5 cm nodule in the deep lobe of the right parotid. The patient was taken to surgery, and during the procedure, it was noted that movement of the mass elicited activity on the nerve monitor. The facial nerve was dissected, and the mass appeared to originate from the nerve. Biopsies were taken, and frozen section was consistent with schwannoma. The surgical procedure was halted to avoid damage to the facial nerve, which was intact postoperatively. Permanent sections showed a lesion composed predominantly of Antoni B tissue which was strongly and diffusely S‐100 protein‐positive, confirming the diagnosis of schwannoma. An awareness of the possibility of this entity in this anatomic region is important for both surgeons and pathologists in order to avoid overly aggressive surgery which might damage the facial nerve.