An unusual combined glomus vagale and jugular tumor: A case report

Abstract

Introduction and importance: Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells. We report an unusual combined glomus vagal and jugular tumor that was rarely described in the literature to the best of our knowledge. Case presentation A 51 years old female with no pathological history was presented to our ENT department with 6 months’ history of a right latero cervical swelling gradually increasing in size associated with a swallowing difficulties and hoarseness. Preoperatively clinical examination had found vagal and hypoglossal nerve paralysis. Cervical CT scan and MRI had shown glomus jugular tumor. The patient underwent a surgical excision with severe swallowing difficulties and facial palsy in the immediate postoperative period with a mild recovery afterwards. Clinical discussion Paragangliomas of the mesotympanum and jugular foramen most commonly present as a vascular middle ear mass. The most common presenting symptom is pulsatile tinnitus occurring in 80% followed by hearing loss (60%). Dysfunction of cranial nerves traversing the jugular foramen may be commonly encountered with resultant abnormalities of speech, swallowing and airway function. Vagal paragangliomas are the least common of the three primary craniocervical paragangliomas. The most common presenting sign is the presence of a painless neck mass accompanied occasionally by dysphagia and hoarseness. The association of both glomus vagal and jugular tumor is rarely described in the literature to the best of our knowledge. Conclusion Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells. Vagal paragangliomas are the least common of the three primary craniocervical paragangliomas. The association of both glomus vagal and jugular tumor is rarely described in the literature to the best of our knowledge. The choice of treatment depends on the location, size, and also biologic activity of the tumor as well as the physical condition of the patient.

Preoperative Endovascular Embolization of Intracranial Hemangioma: A Case Report

“…2 Hekster et al reported the first successful tumor embolization case in 1974, when they used transfemoral catheterization to embolize a meningioma. 3 Since then, many reports and case series have been published describing the advantages of the procedure. However, there is still no standard consensus on how the tumor embolization procedure should be done.…”

Bilateral visual disturbances caused by a glomus vagale: illustrative case

“…They primarily originate from the carotid body, followed by the jugular bulb, the vagus nerve, the tympanic branch of the glossopharyngeal nerve or the auricular branch of the vagus nerve, and the cervical sympathetic chain. 3 …”

“… 1 Thus, early recognition of paragangliomas that require treatment increases the chances of complete tumor removal and decreases the morbidity associated with surgery or radiosurgery. 3 …”

“…They primarily originate from the carotid body, followed by the jugular bulb, the vagus nerve, the tympanic branch of the glossopharyngeal nerve or the auricular branch of the vagus nerve, and the cervical sympathetic chain. 3 Most paragangliomas are classified as slow-growing tumors and have a higher prevalence in females during their sixth and seventh decades of life. Glomus vagale tumors, because of their mass effect, can affect neighboring structures near the jugular foramen.…”

Vagal paraganglioma extending to the brain: a case report with literature review

“…Paragangliomas are uncommon neuroendocrine tumors arising from paraganglion tissues [1] . Extra-adrenal localization of these tumors happens in only 10% of the cases [2] .…”