First reported case of tracheal schwannoma presenting with syncope: diagnostic challenges and surgical management.

Introduction: Tracheal schwannoma is a rare benign neurogenic tumor originating from Schwann cells of the peripheral nerve sheath and accounts for less than 0.2% of all primary tracheal tumors. It commonly presents with nonspecific respiratory symptoms such as wheezing, dyspnea, or cough, often mimicking more common conditions like asthma. Syncope, a clinical manifestation not previously reported, is a rare presentation of tracheal schwannoma. Case presentation: The authors report a case of a middle-aged man with unexplained syncope, accompanied by a history of chronic cough and shortness of breath. Contrast-enhanced computed tomography (CT) identified a tracheal mass as the underlying cause of his symptoms. Histopathological analysis confirmed the diagnosis of tracheal schwannoma. The patient underwent tracheal resection and reconstruction, resulting in complete tumor removal, with no recurrence observed during follow-up. Discussion: Tracheal schwannomas are rare benign tumors, typically presenting with nonspecific respiratory symptoms. This case describes an unusual presentation of syncope, likely due to airway obstruction and vagal compression. The diagnosis was confirmed by CT and histopathology, with surgical resection achieving complete tumor removal and symptom resolution. This highlights the importance of considering rare airway tumors in patients with syncope and respiratory symptoms, underscoring the need for timely diagnosis and intervention. Conclusion: To the best of our knowledge, this is the first reported case of tracheal schwannoma presenting with syncope. It highlights the importance of considering rare airway tumors in patients with unexplained syncope and chronic respiratory symptoms and reinforces the value of timely imaging and surgical intervention for optimal outcomes.