Glomus vagale paraganglioma

Last revised by Joshua Yap on 31 Jan 2023

Glomus vagale tumors are paragangliomas that occur along the path of the vagus nerve (CN X). They are a subset of extra-adrenal neuroendocrine tumors that are derived from the nonchromaffin paraganglion cells

Typically presents as a painless mass behind the carotid artery. Vocal cord paralysis is a relatively frequent finding (~47%) 3.

For a general discussion on the pathology of these tumors, please refer to the parental article on paragangliomas

Although they could occur at a similar position to carotid body tumors 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.

Difficult to sonographically differentiate between other lesions that can potentially occur in this location. It may be seen as a solid heterogeneously hypoechoic lesion comprising small vascular structures 3.

  • T1: usually low signal

  • T2: high signal with multiple flow voids, which may give a salt and pepper appearance

  • T1 C+ (Gd): intense enhancement

The differential for lesions in this location include 2,4:

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Cases and figures

  • Figure 1: distribution of paragangliomas
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  • Case 1
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  • Case 2
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  • Case 3: ultrasound
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  • Case 4: DSA
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