Question 1208
{"accessible":false,"alternatives":[{"id":6050,"text":"Carotid body paraganglioma"},{"id":6051,"text":"Glomus vagale paraganglioma"},{"id":6052,"text":"SCC nodal metastasis"},{"id":6053,"text":"Sympathetic chain schwannoma"},{"id":6054,"text":"Vagal schwannoma"}],"archived":false,"correctAlternativeId":6054,"explanation":"\u003cp\u003eA tumor of the vagus\u0026nbsp;nerve will typically displace the internal carotid artery medially away from the internal\u0026nbsp;jugular vein. Cystic degeneration is common in large schwannomas making vagal schwannoma the likely diagnosis in this case.\u0026nbsp;\u003c/p\u003e\u003cp\u003eA carotid body tumor of this size would displace the internal carotid artery posteriorly away from the external carotid artery. A glomus vagale would displace the vessels in the way described in the case, however it\u0026nbsp;would be very unlikely to show\u0026nbsp;cystic change and instead will display a pepper appearance due to small vascular flow voids.\u003c/p\u003e\u003cp\u003eSquamous cell carcinoma nodal metastases would be very unlikely to seperate the internal carotid artery away from the internal jugular vein, instead the vessels would remain together.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\u003cp\u003eA sympathetic schwannoma would typically displace both\u0026nbsp;the internal carotid artery and internal jugular vein laterally, and would usually demonstrate solid enhancement without cystic change.\u003c/p\u003e","id":1208,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2666","nextQuestionPath":"/articles/schwannoma/questions/1088","relatedArticles":[{"id":4629,"title":"Carotid body tumor","link":"/articles/carotid-body-tumour?lang=us"},{"id":5945,"title":"Vagal paraganglioma","link":"/articles/vagal-paraganglioma?lang=us"}],"alsoUsedIn":[{"id":429,"kind":"Course","title":"Radiology Review Course - Melbourne - page 429","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2019/pages/429"},{"id":429,"kind":"Course","title":"Radiology lectures for ENT Trainees - page 429","link":"https://radiopaedia.org/courses/radiology-lectures-for-ent-trainees/pages/429"},{"id":429,"kind":"Course","title":"Radiology Review Course - Melbourne - page 429","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2020/pages/429"},{"id":429,"kind":"Course","title":"Head \u0026 Neck Lectures - page 429","link":"https://radiopaedia.org/courses/head-neck-lectures/pages/429"},{"id":429,"kind":"Course","title":"Radiology Review Course - page 429","link":"https://radiopaedia.org/courses/radiology-review-course-online/pages/429"},{"id":617,"kind":"Course","title":"Radiopaedia 2020 - Lectures Only - page 617","link":"https://radiopaedia.org/courses/radiopaedia-2020-exclusive/pages/617"},{"id":617,"kind":"Course","title":"2020 Virtual Conference Private Use - page 617","link":"https://radiopaedia.org/courses/2020-virtual-conference-private-use/pages/617"}],"stem":"\u003cp\u003eA 50-year-old male is investigated with MRI and found to have a solitary 6 cm enhancing carotid space mass. It displaces the internal carotid artery medially while the\u0026nbsp;internal jugular vein remains lateral to the mass. It is well-defined with cystic areas.\u0026nbsp;Which is the most likely diagnosis?\u0026nbsp;\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1208"}],"attemptsPercentages":[{"alternativeId":"6051","percentage":13},{"alternativeId":"6052","percentage":2},{"alternativeId":"6053","percentage":11},{"alternativeId":"6050","percentage":10},{"alternativeId":"6054","percentage":63}],"promptToLogin":false,"questionManager":false,"articleId":"schwannoma"}