Intrathoracic vagus nerve tumours.

Strickland, B. and Wolverson, M. K. (1974).Thorax, 29, 215-222. Intrathoracic vagus nerve tumours. Three new cases of intrathoracic vagus nerve sheath tumour are presented. Two were neurofibromas associated with generalized neurofibromatosis, the third a neurilemmoma. All three presented as tumours of the superior middle mediastinum on the left in close association with the aortic arch. Previously reported cases are reviewed with special reference to the anatomical position and mode of clinical presentation. The tumours most often occur on the proximal part of the nerve close to the aortic arch and more often on the left than the right. They usually present as an incidental finding on a chest radiograph. To explain this anatomical localization it is suggested that the tumours tend to occur on the bulkiest part of the nerve which is in the upper thorax and where there is room for growth which is below the thoracic inlet. Proximal vagal tumours are more easily seen on a chest radiograph than those occurring distally and are therefore more likely to be detected. Symptoms occur only with proximal lesions.