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Superficial tissues » General
Carotid body tumor
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Author(s) :
Taco Geertsma, MD
 
Presentation 56 year old female patient with a painles palpable mass on the right side of the neck present since more than a year
 
 
 
Caption: Longitudinal image of the right side of the neck at the level of the carotid artery bifurcation
Description: There is an oval shaped hypoechoic mass in close relation to the carotid bifurcation
 
 
 
Caption: Transverse image of the right side of the neck at the level of the carotid artery bifurcation
Description: There is an oval shaped hypoechoic mass in close relation to the carotid bifurcation
 
 
 
Caption: Longitudinal image of the right side of the neck
Description: The mass is highly vascularized
 
 
 
Caption: Transverse image of the right side of the neck
Description: The mass is highly vascularized
 
 
 
Caption: Transverse image of the left side of the neck at the level of the carotid artery bifurcation
Description: There is no mass lesion at the carotid artery bifurcation on the left side
 
 
 
Caption: Longitudinal image of the left side of the neck at the level of the carotid artery bifurcation
Description: There is no mass lesion
 
 
Caption: Right neck, transverse plane
Description: Right neck, transverse plane. Sweep from common carotid to beyond bifurcation.
 
 
Caption: Right neck, transverse plane, color Doppler
Description: Sweep from base of neck through bifurcation and mass.
 
Differential Diagnosis

The most common cause of a hypoechoic mass along the carotid arteries is an enlarged lymph node. The aspect of the lesion between the carotid arteries in the bifurcation with encasement of the vessels and the irregular hypervascularity are atypical for a pathological lymph node.

In this case the mass represents a carotid body tumor.

 
Final Diagnosis Carotid body tumor
 
Discussion

This type of tumor was first described in 1762 by Haller and called a glomus tumor because of the glomus like structure of the tumor. Later the tumor was also named a chemodectoma or a paraganglioma.

Glomus tumors of the head and neck paraganglia are part of the extra-adrenal neuroendocrine system

Carotid body tumors usually present as a painless mass in the neck and tend to be asymptomatic. Because of its close relation to the carotid arteries they can pulsate. Sometimes a bruit can be heard over the mass.

 

The following features are commonly seen with ultrasound:
- A well-defined solid mass in the neck that may be unilateral or bilateral.
- The mass is usually hypoechoic. Anechoic tubular channels representing small vessels may be seen within the mass.
- The mass is found in close proximity to the carotid bifurcation often with widening of the bifurcation

- Color Doppler demonstrates significant internal vascularity within the mass The feeding aereries arise from the external carotid artery, although the internal carotid and the vertebral artery may also supply the carotid body tumor.
- On spectral analysis, low resistance flow may be detected within the mass.
For more examples of carotid body tumors see www.ultrasoundcases.info

 
Case References

Alkadhi H, et al. Evaluation of topography and vascularization of cervical paragangliomas by magnetic resonance imaging and color duplex sonography. Neuroradiology. 2002 Jan; 44(1):83-90.
Arslan H, Unal O, Kutluhan A, Sakarya ME. Power Doppler scanning in the diagnosis of carotid body tumors.  J Ultrasound Med. 2000 Jun; 19(6):367-70.

 
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