Vagal paraganglioma: imaging versus intraoperative findings

A 59-year-old woman presented with a mass on the jugulo-digastric level. Inspection of the oral cavity showed medial bulging of the left pharyngeal wall and tonsil. Transcutaneous ultrasonography showed a vascular tumor of the parapharyngeal space with complete encirclement of the internal carotid artery. Magnetic resonance angiography and common carotid angiography showed the bloody support from the external carotid artery of that tumor. During the surgical procedure, we identified the tumor, who arises from the vagus nerve and who had multiple fine arterial branches from the internal carotid artery until the skull base. We performed complete resection of the parapharyngeal tumor, by transcervical approach, with sacrificed the vagus nerve. The histopathological report showed a vagal paraganglioma. After one year is no sign of recurrence.