Glomus Vagale Tumors

Abstract

We present a case of a multicentric chemodectoma, with the unusual combination of a glomus vagale and a glomus tympanicum tumor. Multicentricity was suspected before selective carotid arteriography. Our patient, although asymptomatic, had elevated levels of urinary catecholamines preoperatively, which returned to normal postoperatively, suggesting biochemical activity of the tumor. Intraoperative hemostasis was assisted by the use of preoperative selective embolization of the tumor mass and the peripheral location of the injected Ivalon was confirmed histologically. The vagus nerve was anatomically spared and complete function was restored within 10 months. The asymptomatic small glomus tympanicum tumor was treated with embolization alone, as the patient chose to defer treatment at this time, but only time will reveal the effectiveness of this method of management.

An Unusual Cause of Reflex Cardiovascular Syncope: Vagal Paraganglioma

“…The extra‐adrenal neuroendocrine system is a complex system dispersed throughout the body with a regulatory function. Vagal paraganglioma (VP) originates from the paraganglia cells within the vagal nerve and is the third most common paraganglioma of the head and neck after carotid body tumors and jugulotympanic paragangliomas 1 . They account for less than 5% of all head and neck paragangliomas 1,2 .…”

“…Vagal paraganglioma (VP) originates from the paraganglia cells within the vagal nerve and is the third most common paraganglioma of the head and neck after carotid body tumors and jugulotympanic paragangliomas 1 . They account for less than 5% of all head and neck paragangliomas 1,2 . The tumor typically manifests as a painless, slowly growing mass in the neck 3,4 .…”

Management of Vagal Paragangliomas Including Application of Internal Carotid Artery Stenting

“…Some authors [Browne et al, 1993;Davidson and Gullane, 1988;Eriksen et al, 1991;Miller et al, 2000;Ogura et al, 1978;Wong et al, 1987] advocate preoperative embolization, but others [Biller et al, 1989;Black et al, 1977;Forbes et al, 1986;Urquhart et al, 1994] do not. In our practical experience, the decision for embolization depends on tumor size and angiographic findings.…”

Dumbbell-Shaped Paraganglioma of the Cervical Spine in a Child

“…Preoperative embolization is considered a useful adjunctive tool in surgical management of large (>3 cm) paragangliomas [23]. Most paragangliomas are considered radioresistant, and radiation therapy (RT) as a primary modality of treatment for paragangliomas is not recommended [24]. In patients with unresectable tumors and residual tumors following surgery, RT may serve as an excellent palliative modality [25].…”