• Tiehao Wang, Jiarong Wang, Jichun Zhao, Ding Yuan, and Wenqing Yao.
• Department of Vascular Surgery.
• Medicine (Baltimore). 2021 Feb 5; 100 (5): e24386e24386.

RationaleMalignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas arising from peripheral nerves. MPNSTs are uncommon in the head and neck, and various clinical manifestation often make the diagnosis challenging.Patient ConcernsA 67-year-old female was referred for evaluation of repetitive syncope with a massive mass in the neck. Preoperative evaluation revealed potential neuroendocrine activity of the mass and enhanced computed tomography showed carotid artery was involved.DiagnosisAccording to the preoperative imaging, intraoperative finding and postoperative pathological examination, the diagnosis of left neck MPNST involving left carotid arteries was made.InterventionsVolume expansion therapy with phenoxybenzamine started one week before surgery. Complete surgical resection of the mass was performed and pathological analysis suggested the diagnosis of MPNST. The postoperative radiotherapy was not given due to her poor nutrition.OutcomesThis patient recovered well after surgery and no sign of recurrence was noted at 2-year follow-up.LessonsThough the involvement of carotid artery with neuroendocrine activity is rare in sporadic MPNST, preoperative scanning of blood and urine catecholamine is crucial for intraoperative hemodynamic stability, especially when carotid artery is involved.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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