case_images: PMC8407632_01
case_images: Multiple swellings of the anterior/posterior trunk and the left forearm of the patient
case_images: AMS-11-144-g001.jpg
case_images: PMC8407632_01_AMS-11-144-g001.jpg
case_images: F1
case_images: The patient had multiple swellings of his scalp, trunk, and left arm [Figure 1].
case_images: Left-sided huge swelling of the neck (note the tracheal shift to the right side due to mass effect)
case_images: AMS-11-144-g002.jpg
case_images: PMC8407632_01_AMS-11-144-g002.jpg
case_images: F2
case_images: 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].
case_images: Tongue deviation to the left (affected) side
case_images: AMS-11-144-g003.jpg
case_images: PMC8407632_01_AMS-11-144-g003.jpg
case_images: F3
case_images: Cranial nerve examination showed no abnormalities other than tongue deviation to the left side, which is consistent with left hypoglossal nerve involvement [Figure 3].
case_images: Coronal, axial, and sagittal magnetic resonance imaging demonstrating a large homogenous encapsulated mass in the left carotid space
case_images: AMS-11-144-g004.jpg
case_images: PMC8407632_01_AMS-11-144-g004.jpg
case_images: F4
case_images: 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.
case_images: Coronal and sagittal magnetic resonance imaging of the brain showing multiple meningiomas and bilateral acoustic schwannomas
case_images: AMS-11-144-g005.jpg
case_images: PMC8407632_01_AMS-11-144-g005.jpg
case_images: F5
case_images: In addition, MRI of the brain [Figure 5] showed multiple meningiomas with bilateral acoustic schwannomas; findings were consistent with neurofibromatosis type II.
case_images: Intraoperative pictures of the mass and the excised patient's specimen
case_images: AMS-11-144-g006.jpg
case_images: PMC8407632_01_AMS-11-144-g006.jpg
case_images: F6
case_images: An ovoid well-circumscribed mass, with smooth yellow/tan outer surface showing prominent vascular arborization, was identified medial to the carotid sheath [Figure 6].
case_images: 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)
case_images: AMS-11-144-g007.jpg
case_images: PMC8407632_01_AMS-11-144-g007.jpg
case_images: F7
case_images: 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.