Plexiform neurofibroma of the cervical portion of the vagus nerve

Abstract

The authors describe a rare case of plexiform neurofibroma of the cervical portion of the vagus nerve, and discuss its aetiopathogenesis, clinical, histological and therapeutic features, emphasizing the difference from other benign tumours of the vagus nerve.The clinical characteristics of the mass, ultrasound tomography, CT scanning and digital subtraction angiography were useful in defining its extension and relationships with the surrounding structures.Surgery is the treatment of choice. After mentioning the most commonly employed surgical approaches, they emphasize the advantages of the lateral-cervical approach which allows a wide exposure of the possible sites of origin of the tumour and its complete removal.Finally they stress the need of an accurate histological and immunohistochemical examination in order to differentiate neurofibromas from neurilemmomas.

CT and MRI Evaluation of Nerve Sheath Tumors of the Cervical Vagus Nerve

“…The inferior vagal ganglion, or nodose ganglion, is larger in diameter; is located just below the skull base; and is seen as a 2.5-cm-long cylindric structure that blends with the vagal trunk below [8,9]. Several authors believe that vagal schwannomas tend to arise near this nodose ganglion and that neurofibromas arise more randomly along the course of the cervical vagus nerve [1,10,11]. Although tumor location was not recorded intraoperatively, from the fact that eight of the nine vagal schwannomas in this study (almost 89%) were predominantly located in the suprahyoid neck, we are inclined to attribute this pattern of distribution to the aforementioned hypothesis of their origin being at the nodose ganglion.…”

Cavernous hemangioma of infrahyoid carotid sheath and review of the literature on carotid sheath tumors

“…Neuromas are rare encapsulated tumors, almost exclusively benign,8 deriving from the perineural cells of the nerve sheath. Neurofibromas derive from the perineural cells which produce connective tissue, in contrary to neuromas that arise from the endoneural Schwann cells and only little connective tissue is contained 9. Attention should be paid, because of the sporadical presentation of neurofibromas with neurofibromatosis (von Recklinghausen's disease) 10.…”

Sonography of the Cervical Vagus Nerve

“…Paraganglioma, also referred to as chemodectoma, is less common, arises from either the vagus nerve or the carotid body, and is rarely malignant [4][5][6][7][8]. Schwannoma, neu- rinoma, and neurofibroma are histologically similar and may arise from the vagus nerve or other peripheral nerves (neurofibromas are generally found in patients affected by von Recklinghausen's disease).…”