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Vagal Schwannoma - Radiology

last modified on: Thu, 04/25/2024 - 11:14

Updated by Piper Wenzel, BS April 2024

​return to: Collett-Sicard Syndrome

  • Also called neuroschwannoma, neuroma, or neurilemmoma (Loperfido 2023)
  • Around 25-45% of extracranial schwannomas occur in the head and neck region (Sandler 2019)
  • Benign uncommon tumor of the CN X Schawnn cells (Loperfido 2023)
  • Most cases present between the 3rd to 5th decades; female = male (Loperfido 2023)
  • Usually asymptomatic but may cause hoarsness due to vocal cord paralysis (Loperfido 2023)
  • Larger tumors may present with dysphagia, dysphonia, and dyspnea due to airway obstruction (Loperfido 2023)
  • Displaces internal jugular vein posterolaterally; displaces common and internal carotid arteries anteriorly (Sandler 2019)
  • Ultrasound: "round or elliptical cross-section with a clear edge and an internal echo reflective of histology"; may have cystic changes (Loperfido 2023)
  • On CT: Muscle density mass on non-contrast, uniformly enhancing and well-circumscribed mass with contrast
  • On MR: variable signal with no flow voids on T1, hyperintense with possible cystic structures on T2, dense and uniform enhancement of T1 post-contrast

 T1-weighted MR

VagSchwan_T1_0720

T2-weighted MR

VagSchwan_T2_0720

References

Loperfido A, Celebrini A, Fionda B, Bellocchi G, Cristalli G. Diagnostic and Therapeutic Strategy for Vagal Schwannoma: Case Series and Literature Review. Medicina (Kaunas). 2023 May 24;59(6):1013. doi: 10.3390/medicina59061013. PMID: 37374217; PMCID: PMC10303656.

Sandler ML, Sims JR, Sinclair C, Sharif KF, Ho R, Yue LE, Téllez MJ, Ulkatan S, Khorsandi AS, Brandwein-Weber M, Urken ML. Vagal schwannomas of the head and neck: A comprehensive review and a novel approach to preserving vocal cord innervation and function. Head Neck. 2019 Jul;41(7):2450-2466. doi: 10.1002/hed.25758. Epub 2019 Apr 7. PMID: 30957342.