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Glomus vagale tumour

Dr Yuranga Weerakkody and Dr Jeremy Jones et al.

A glomus vagale tumour is a subset of glomus tumours which 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 ).

Location

Although they could occur at a similar position to carotid body tumours they tend to be more rostrally in location. They displace the ICA and ECA anteriorly and the IJV 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 comprosing 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 

Differential diagnoses

The differential for lesions in this location include

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