University of Health Sciences, Istanbul Training and Research Hospital, Department of Neurosurgery, Istanbul, Türkiye.
Turk Neurosurg. 2024;34(1):167-170. doi: 10.5137/1019-5149.JTN.40702-22.2.
Vagal paragangliomas (VPs) are rare tumors arising from paraganglionic tissue within the vagal nerve's perineurium. Usually, benign vascular tumors, VPs tend to invade the surrounding structures. Herein, we report the case of a VP presenting as a neck mass, which was evaluated as a glomus caroticum tumor preoperatively. A 65-year-old female complaining of a left-sided neck mass and intermittent hoarseness was assessed and operated on for possible glomus caroticum tumor. During the tumor excision, the vagal nerve was also involved, and hence, sacrificed. Histopathological examination revealed an encapsulated tumor associated with a nerve and ganglion and immunohistochemical staining tested positive for succinate dehydrogenase, confirming the diagnosis of VP. Postoperative residual hoarseness was corrected by vocal rehabilitation. While evaluating a retropharyngeal prestyloid neck mass, a VP should always be considered. Surgical excision involving vagal scarification, followed by vocal rehabilitation may be the appropriate treatment strategy.
迷走神经副神经节瘤（VPs）是一种罕见的肿瘤，起源于迷走神经神经外膜中的副神经节组织。通常为良性血管性肿瘤，VPs 倾向于侵犯周围结构。本文报告了一例表现为颈部肿块的 VP 病例，术前评估为颈动脉球瘤。一名 65 岁女性因左侧颈部肿块和间歇性声音嘶哑就诊，并接受了可能的颈动脉球瘤手术。在肿瘤切除过程中，迷走神经也受累并被牺牲。组织病理学检查显示与神经和神经节相关的包膜肿瘤，免疫组织化学染色对琥珀酸脱氢酶呈阳性，确诊为 VP。术后残留的声音嘶哑通过发声康复得到纠正。在评估咽后茎突前颈部肿块时，始终应考虑到 VP。涉及迷走神经切开的手术切除，随后进行发声康复可能是适当的治疗策略。
