A Synchronous Phenomena: Congenital Neck Schwannoma and Cavernous Lymphangioma in a Neonate—A Case Report

Background: Congenital neck masses in neonates are uncommon and are most frequently benign, with lymphatic malformations occurring more often than neoplastic lesions. The synchronous presence of two distinct congenital pathologies is exceedingly rare and presents significant diagnostic and management challenges.

Objectives: We report a rare case of a full-term neonate presenting at birth with a neck mass and macroglossia causing airway compression, highlighting the diagnostic and therapeutic approach to managing complex congenital neck masses.

Methods: Prenatal imaging suggested a congenital lymphangioma. The patient underwent surgical excision of the neck mass and tracheostomy to secure the airway. Histopathologic examination revealed features consistent with a schwannoma. At two years of age, the patient developed progressive macroglossia, resulting in severe feeding difficulties that necessitated hemi-glossectomy. Histopathologic examination revealed a cavernous lymphangioma.

Conclusion: This case represents an exceptionally rare synchronous occurrence of a congenital neck schwannoma and cavernous lymphangioma in a single patient. It underscores the importance of thorough diagnostic evaluation, histopathologic confirmation, and an approach to managing complex congenital neck masses to achieve favorable outcomes.

Keywords: Congenital Schwannoma, Cavernous Lymphangioma, Neonate, Macroglossia

Noreen Kim A. Maligad, MD is a pediatric resident and current Chief Resident at San Pedro Hospital in Davao City, Philippines. She earned her medical degree from Davao Medical School Foundation and is currently undergoing residency training in general pediatrics. Her training includes broad clinical exposure in inpatient, outpatient, and emergency pediatric care. Dr. Maligad has a strong interest in newborn medicine and plans to pursue a career in neonatology, with a focus on improving outcomes for high-risk and critically ill neonates. She is actively involved in academic activities, case presentations, and departmental conferences.