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Vagal schwannomas are uncommon benign masses that can occur anywhere along the course of the vagus nerve but most commonly occur in the cervical region.
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Most commonly occurs in the 3rd to 5th decades. No sex predilection 3.
Patients may be asymptomatic. When symptomatic they can present with a slow-growing mass, most commonly in the neck. Vocal hoarseness or cough on palpation of the neck mass may be features 1-3.
Vagal schwannomas are closely adherent to the vagus nerve, which lies between the internal carotid artery (ICA) and internal jugular vein (IJV) and tends to separate them as well as displacing the ICA anteromedially 4,5.
See the general schwannoma article for further discussion of radiographic features.
For cervical region consider 3:
- sympathetic chain schwannoma: displace the ICA and IJV in the same direction 5
- branchial cleft cyst
- cervical lymphadenopathy, e.g. lymphoma, metastases
- 1. Giuseppe Cavallaro, Giada Pattaro, Olga Iorio, Marcello Avallone, Gianfranco Silecchia. A literature review on surgery for cervical vagal schwannomas. (2015) World Journal of Surgical Oncology. 13 (1): 1. doi:10.1186/s12957-015-0541-6 - Pubmed
- 2. Mat Lazim N. Challenges in managing a vagal schwannomas: Lesson learnt. (2018) International journal of surgery case reports. 53: 5-8. doi:10.1016/j.ijscr.2018.10.025 - Pubmed
- 3. Chiofalo MG, Longo F, Marone U, Franco R, Petrillo A, Pezzullo L. Cervical vagal schwannoma. A case report. (2009) Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale. 29 (1): 33-5. Pubmed
- 4. G. Anil, T.Y. Tan. Imaging Characteristics of Schwannoma of the Cervical Sympathetic Chain: A Review of 12 Cases. (2010) American Journal of Neuroradiology. 31 (8): 1408. doi:10.3174/ajnr.A2212 - Pubmed
- 5. Aaron D. Skolnik, Laurie A. Loevner, Deepak M. Sampathu, Jason G. Newman, John Y. Lee, Linda J. Bagley, Kim O. Learned. Cranial Nerve Schwannomas: Diagnostic Imaging Approach. (2016) RadioGraphics. 36 (5): 1463-77. doi:10.1148/rg.2016150199 - Pubmed