Abstract
Nerve sheath tumours of the sympathetic chain are extremely rare and present a diagnostic challenge. A 42-year-old female presented with asymptomatic left cervical swelling. Imaging with sonography, CT, MR and angiography demonstrated a lesion splaying the carotid bifurcation, the lyre sign. Following surgical excision, histology revealed a schwannoma. Imaging features of carotid body tumours and parapharyngeal schwannomas can be similar, as both can cause splaying of the carotid bifurcation. The differential diagnosis of such tumours and their management are discussed. CONTRIBUTION: This article highlights another cause of the lyre sign on radiological imaging besides carotid body tumours.