Vagal paraganglioma
Updates to Article Attributes
Glomus vagale tumours are glomus tumours that occur along the path of the vagus nerve (CN X). They are a subset of extra-adrenal neuroendocrine tumours that are derived from the nonchromaffin paraganglion cells.
Clinical presentation
Typically presents as a painless mass behind the carotid artery. Vocal cord paralysis is a relatively frequent finding (~47%) 3.
Pathology
Location
Although they could occur at a similar position to carotid body tumours they tend to be more rostral in location and do not widen the carotid bifurcation. They displace the internal and external carotid arteries anteriorly, and the internal jugular vein posteriorly 1.
Radiographic features
Ultrasound
Difficult to sonographically differentiate between other lesions that can potentially occur in this location. May be seen as a solid heterogeneously hypoechoic lesion comprising of small vascular structures 3.
MRI
- T1: usually low signal
- T2: high signal with multiple flow voids, which may give a salt and pepper appearance
- T1C+: intense enhancement
Differential diagnoses
The differential for lesions in this location include 2,4:
-
vagal nerve schwannoma
/ neurofibroma/neurofibroma - carotid space meningioma (extends from jugular foramen)
-<strong>T2:</strong> high signal with multiple flow voids which may give a salt and pepper appearance </li>- +<strong>T2:</strong> high signal with multiple flow voids, which may give a salt and pepper appearance</li>
-</ul><h4>Differential diagnoses</h4><p>The differential for lesions in this location include <sup>2,4</sup></p><ul>- +</ul><h4>Differential diagnoses</h4><p>The differential for lesions in this location include <sup>2,4</sup>:</p><ul>
-<a href="/articles/vagal-nerve-schwannoma">vagal nerve schwannoma</a> / neurofibroma</li>- +<a href="/articles/vagal-nerve-schwannoma">vagal nerve schwannoma</a>/neurofibroma</li>