Glomus Vagale Paraganglioma, right

22-year-old male presented for evaluation of hoarseness. Arising along the posteromedial aspect of the right carotid sheath, between the right carotid arterial system superior to the bifurcation and the right internal jugular vein, there is a circumscribed, T1-isointense mass with avid, heterogeneous, postcontrast enhancement and mild diffusion restriction. The lesion was hyperintense on the T2/STIR-weighted images, and several prominent flow voids were identified. The lesion splays the carotid and jugular vessels. Differential includes right glomus vagale paraganglioma, vagal schwannoma, neurofibroma and carotid space meningioma. This is a right glomus vagale paraganglioma. Glomus vagale are avidly enhancing masses in nasopharyngeal carotid space arising approximately 2 cm below the jugular foramen. Multiple lesions can be seen with hereditary paraganglioma and pheochromocytoma syndrome, multiple endocrine neoplasia-2, and von Hippel-Lindau syndrome.