Vagus Nerve Neurofibroma

Vagus nerve neurofibromas are very rare. They can be located in cervical or mediastinal positions. They are slowly growing and typically asymptomatic.

While the vagus nerve itself can be hard to see, knowledge of the anatomy can be helpful in localization. The vagus nerve travels from the jugular foramen in the carotid sheath between the internal jugular vein (IJ) and internal carotid artery above C4 and between the IJ and common carotid artery (CC) to the root of neck.

The case above shows a T2-hyperintense structure between the IJ and CC at the base of the neck. In this patient with neurofibromatosis, the primary consideration is a vagus nerve neurofibroma.

References

• Gilmer-Hill HS, Kline DG. Neurogenic tumors of the cervical vagus nerve: report of four cases and review of the literature. Neurosurgery. 2000 Jun;46(6):1498-503.
• Kanzaki R, Inoue M, Minami M, Sawabata N, Shintani Y, Nakagiri T, Okumura M. Bilateral mediastinal neurofibroma of the vagus nerves in a patient with neurofibromatosis type 1. Ann Thorac Cardiovasc Surg. 2013;19(4):293-6.
• Matejcik V, Steno J, Haviarova Z, Mravec B. Neurofibroma of the vagus nerve in the cervical portion. Bratisl Lek Listy. 2008;109(10):455-8.
• Sesenna E, Magri AS, Corradi D, Ferri T, Ferri A. Malignant peripheral nerve sheath tumor of the vagus nerve in a teenager with the neurofibromatosis 1 gene mutation: a case report. J Pediatr Surg. 2011 Aug;46(8):e9-12.
• Shintani Y, Ohta M, Hazama K, Minami M, Okumura M, Hirabayashi H, Matsuda H. Bilateral cervicomediastinal neurofibroma originating from the vagal nerve in a patient with von Recklinghausen's disease: report of a case. Surg Today. 2002;32(12):1068-71.