Background: Intraabdominal schwannomas are rare tumors mostly occur in patients with neurofibromatosis. Tumors arisen from vagus nerve are rarer especially in sporadic cases. 

Case: A 34-year-old man admitted in surgery ward Milad Hospital, in Tehran, Iran with long-lasting vomiting, dysphagia, and cachexia for four years. Multiple previous paraclinical assessments were normal, he had been treated as anorexia nervosa for three years without improvement. Our evaluations showed a mass in diaphragmatic hiatus. Explorative laparotomy revealed a mass parallel to distal esophagus, which was resected completely. Immunohistochemical examinations revealed a benign schwannoma. After surgery, the patient's symptoms recovered and he returned to normal life.

Conclusions: Vagus nerve schwannoma can present with dysphagia and cachexia with normal endoscopic evaluations. It is important to rule out physical causes in patients with cachexia who are treated with psychiatric diagnoses.