LAUSR

BACKGROUND Hypoglossal schwannomas are rare, benign intracranial neoplasms; they represent 5% of all non-vestibular schwannomas. CLINICAL CASE A 22-year-old male patient who presented 4 months prior to admission with left sided hearing loss, an increase in the base of support with lateralization to the left and dysphagia to solids. Physical examination on admission shows hypotrophy of the tongue and deviation to the left. Magnetic resonance imaging shows evidence of an extra axial lesion compressing the medulla oblongata and pons, that protrudes through the hypoglossal canal. Patient is planned for surgical treatment in two stages: in the first surgery, a left retrosigmoidal approach with total resection of the intracranial lesion was performed. The biopsy reported a schwannoma and correlating the signs, symptoms and imaging, the diagnosis of a hypoglossal nerve schwannoma was established. In the second surgery, a lateral cervical approach was performed, with subtotal resection of the lesion, leaving a remnant adhered to the nerve in the hypoglossal canal. CONCLUSION Hypoglossal schwannomas are a rare entity, in which surgery is the most viable option with high cure rates. However, its complete resection, without leaving permanent neurological sequels, is a challenge.