A case of cervical vagus neurinoma with hypoglossal palsy

: Cervical vagus neurinoma with hypoglossal palsy is extremely rare and only one case has been reported so far in Japan. A 52-year-old female complained of dysarthria. She has hypoglossal palsy with left-deviated tongue and the left half of her tongue was markedly atrophic. Cervical mass was not palpable and she had no other complaint such as hoarseness or dysphagia. CT scan and MRI revealed a tumor at a caudal part of the left jugular foramen. A hypoglossal canal was intact. Cerebral angiography demonstrated arterio-venous dissociation but vascular formation or tumor stain was not revealed. The tumor was totally removed by transpetrosal approach. The vagus nerve became thicker above C2 level and changed into the yellowish tumor with clear margin. The hypoglossal nerve was compressed between the tumor and an occipital bone. The authors think this is why hypoglossal palsy appeared. Histologically, the tumor was neurinoma. Clinical symptoms, diagnosis, and treatment were discussed.