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Clinical Manifestations:

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Vagal paragangliomas: two case reports.

C Caldarelli¹, C Iacconi, C Della Giovampaola

¹Department of Otorhinolaryngology and Maxillofacial Surgery, ASL 4, Turin, Italy. claudio.caldarelli@fastwebnet.it

Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-Facciale

|September 22, 2007

Summary

Vagal paragangliomas are rare tumors, often benign and non-functioning, predominantly affecting middle-aged women. Complete surgical removal while preserving vagus nerve function remains challenging, necessitating post-operative rehabilitation.

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Area of Science:

Neuro-oncology
Head and Neck Surgery

Background:

Paragangliomas are rare neuroendocrine tumors that can arise from various locations, including the vagus nerve.
Vagal paragangliomas are particularly uncommon, presenting diagnostic and therapeutic challenges.

Observation:

This report details two rare cases of vagal paragangliomas, highlighting diagnostic methods like computed tomography and digital angiography.
The cases underscore the tendency for these tumors to occur in middle-aged females, sometimes as multiple lesions.

Findings:

Histological examination revealed benign features, with no neurological symptoms, local invasion, or intracranial extension observed.
The tumors were non-functioning, indicated by the lack of catecholamine secretion, consistent with the low incidence of functioning vagal paragangliomas.
Contrast computed tomography and digital angiography are confirmed as reliable diagnostic tools, despite advancements in MRI and octreotide scintigraphy.

Implications:

Surgical management, even with a transcervical approach for large tumors, often results in incomplete removal or damage to the vagus nerve.
Post-operative neurological morbidity, particularly affecting deglutition and phonation, remains a significant concern, emphasizing the need for comprehensive rehabilitation strategies.