Vagal Nerve Paraganglioma in a Middle-Aged Woman: A Case Report.

Paragangliomas are rare neuroendocrine tumors arising from extra-adrenal paraganglionic tissue, with head and neck involvement representing an uncommon subset. Among these, vagal paragangliomas are particularly rare and typically present as slow-growing, non-functional cervical masses, posing diagnostic and therapeutic challenges due to their proximity to major neurovascular structures. We report the case of a 45-year-old woman with a two-year history of a progressively enlarging right-sided cervical mass without systemic or catecholamine-related symptoms. Imaging studies, including contrast-enhanced computed tomography and computed tomography angiography, revealed a hypervascular tumor within the carotid space with partial encasement of the carotid arteries. The patient underwent complete surgical resection, and histopathological examination confirmed the diagnosis of paraganglioma. Although biochemical evaluation for catecholamine secretion was not performed preoperatively, the patient had an uneventful postoperative course, with preserved vocal function and no evidence of recurrence at one-year follow-up. This case highlights the importance of considering vagal paraganglioma in the differential diagnosis of cervical masses, as well as the critical role of imaging and biochemical assessment in preoperative evaluation. Surgical management remains the mainstay of treatment but carries a significant risk of cranial nerve injury, underscoring the need for careful planning and long-term follow-up.