Vagal Paraganglioma: Case Report and Review of Literature

When a patient presented at our institution with pulsatile tinnitus, we discovered an underlying vagal paraganglioma and wanted to make a clear overview on what is known of the benign tumor. A PubMed search was conducted for relevant review and original research articles based on their clinical relevance and scientific strength. Vagal paragangliomas present as a painless cervical mass, but symptoms can also be caused by compression of adjacent vascular and neural structures. Twenty percent of patients have a positive familial history of paraganglioma, and almost 50% of cases can be explained by an underlying genetic mutation, with SDHD being the most common. Diagnosis with computed tomography (CT), magnetic resonance imaging, or 68Ga-DOTA-SSTRTs Positron emission tomography/CT has a 100% specificity. The treatment of choice is a conservative wait-and-scan policy. When tumor growth or tumor-related complications are seen, radiotherapy is an effective treatment to obtain tumor stabilization. Surgery is the treatment of choice in secreting vagal paragangliomas with cardiovascular symptoms, malignant vagal paragangliomas, or tumors with a significant intracranial extension and mass effect.