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NEURORADIOLOGY Table of Contents   
Year : 2005  |  Volume : 15  |  Issue : 3  |  Page : 327-329
Carotid body tumour


Department of Radiodiagnosis & Imaging, Gandhi Medical College & Associated Hamidia Hospital, Bhopal, India

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Keywords: Carotid Body, Paraganglioma, Chemodectomas

How to cite this article:
Malik R, Pandya V K, Parteki S. Carotid body tumour. Indian J Radiol Imaging 2005;15:327-9

How to cite this URL:
Malik R, Pandya V K, Parteki S. Carotid body tumour. Indian J Radiol Imaging [serial online] 2005 [cited 2020 Sep 23];15:327-9. Available from: http://www.ijri.org/text.asp?2005/15/3/327/29147

   Case Report Top


A 35 yr. Man presented to us with a progressively increasing swelling of 4 yrs. of duration in the left side of neck. There were no pressure symptoms. On examination the swelling was more mobile transversely than vertically. Pulsations were felt on deep palpation and a faint bruit was heard on auscultation. Colour doppler study of the neck swelling revels an echogenic mass below the mandible with displacement of internal carotid artery due to the mass [Figure - 1][Figure - 2] medially with blood flow clearly visualized in the mass. On CT scan the mass was well circumscribed & showed splaying of internal & external carotid arteries [Figure - 3]. Post contrast CT showed intense pattern of enhancement [Figure - 4][Figure - 5]. A left carotid angiography and arch aortography showed widening of carotid bifurcation by a vascular mass with tumour blush [Figure - 6][Figure - 7], suggestive of carotid body tumour. Serum catecholamines were within normal limits. Other routine investigation were normal.


   Discussion Top


The carotid body is located at the adventitia of the carotid bifurcation, which regulates pulmonary ventilation through afferent input by way of glossopharyngeal nerve to the medullary reticular formation. A carotid body tumour (CBT), also known as glomus caroticum or carotid paraganglioma, is a benign tumour derived from carotid body, and found in the lateral compartment of the neck [1]. Histopathologically CBT is composed of nest of epitheliod cells with granular eosinophllic cytoplasm, separated by trabeculated vascularised connective tissue. Clinically CBT usually presents as a painless, pulsatile, mass below the angle of jaw, laterally mobile but vertically fixed. It is bilateral in 5% of patients with sporadic occurrence, and in 32% of the patients with autosomal dominant transmission. Carotid body tumour can also be associated with other glomus tumour in head & neck.

Computed tomography and magnetic resonance imaging (MRI) reveal a well circumscribed mass at or above the carotid bifurcation, which splays the internal and external carotid arteries. On post contrast scan there is intense enhancement[2],[3]. The mass usually shows a salt and pepper appearence caused by vessels with signal void within the tumour stroma. Both MR angiography and digital angiography should be done in all suspected cases . It substantiates the diagnosis, indicates the size and vascularity of tumour, determines bilaterality, distal intracranial outflow and collateral circulation [4],[5].

Tissue diagnosis is not necessary and biopsy may be dangerous [6]. Majority of carotid body tumours are benign, but may infiltrate locally. About 3% are malignant [7]. The commonest overt malignant manifestation is local recurrence.

Once diagnosed, excision is the treatment of choice. In inoperable cases radiation therapy is recommended [8].

 
   References Top

1.Win T, Lewin JS. Imaging characteristics of carotid body tumors. Am J Otolaryngol 1995 Sep-Oct; 16(5) : 325-8.  Back to cited text no. 1    
2.Zidi A, Bouaziz N, Mnif N, Kribi L, Kara M, Salah M, Ferjaoui M, Hamza R. Carotid body tumors: contribution of the various imaging techniques. A report of six cases. J Rediol 2000 Sep ; 81 (9) : 953-7.  Back to cited text no. 2    
3.Van den Berg R, Van Gils AP, Wasser MN. Imaging of head and neck paragangliomas with three-dimensional time-of-flight MR angiography. AJR Am J Roentgenol 1999 Jun: 172 (6) : 1667-73.  Back to cited text no. 3    
4.Chambers, R. G. and Mahoney, W.D. : Carotid body tumours, Amer. J. Surg., 116:554-558, 1968.  Back to cited text no. 4    
5.Conley, J.M. : Management of carotid body tumours, Surg., Gynec. And Obstet., 117:722-732, 1963.  Back to cited text no. 5    
6.Harwell, W. : Carotid body tumours, Surgery., 59:483-493, 1966.  Back to cited text no. 6    
7.Batsakis, J.G. : "Tumours of Head of Neok", Williams and Wilkins Co., Baltimore, 1974, Chapter 19, pp. 280-287.  Back to cited text no. 7    
8.Howell, A., Monasterio, J. and Stuteville, O., Chemodectomas of the head and neck, Surg. Clin. North. Amer., 53: 175-177, 1973.  Back to cited text no. 8    

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Correspondence Address:
R Malik
Department of Radiodiagnosis & Imaging, Gandhi Medical College & Associated Hamidia Hospital, Bhopal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.29147

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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7]



 

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