Introduction: Neurofibroma of the vagus nerve in the cervical region is an extremely uncommon benign tumor. Only ten reported cases were found in literature. It is slow growing and most are asymptomatic neck lumps. Preoperative imaging aids in arriving at a differential diagnosis and planning the surgery. Complete surgical excision is the standard of care.
Case Report: A 39-year-old female presented to the general surgical clinic with a painless lump on the right side of the neck for twelve months duration with recent rapid enlargement. Past medical history was unremarkable. She did not have a family history of neurofibromatosis. Physical examination revealed a 4x3.5 cm lump in the upper neck with well-defined margins and smooth surface. Contrast-enhanced CT scan confirmed a 3.6x3.2x6.9 cm hypodense mass with no contrast enhancement. The lesion was in-between right internal and external carotid artery and extending to the base of the skull. Right internal jugular vein was displaced anteriorly. Right common carotid artery (R/CCA) was stretched. The patient underwent exploration of the neck under general anesthesia with loupe magnification. The gross pathology showed a greyish homogenous cut surface of a 55x40 mm tumor. Pathological examination confirmed the diagnosis of neurofibroma of the vagus nerve.
Conclusion: Vagus nerve neurofibromas are rare nerve sheath tumors. Gold-standard treatment of symptomatic benign vagus nerve mass is an attempt at GTR with minimal loss of nerve function.

Keywords: Neurofibroma, Tumor, Vagus nerve