Vagal schwannoma

Discussion:

Vagal schwannoma is an extremely rare tumor that occurs along the path of the vagus nerve (CN X) having its location posterior to the carotid bifurcation (the vagus nerve runs along the posterior aspect of the carotid sheath).

The main differential diagnosis at such location is the vagal paraganglioma, however, schwannoma shows moderate enhancement while paraganglioma shows avid enhancement 1.

The lesion exhibits diffusion restriction and an ADC value of 1.3 x 10-3 mm2/sec attributing some of the diffusion restriction to the high T2 signal 1.

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