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| Year : 2005 | Volume
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| Issue : 3 | Page : 327-329 |
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| Carotid body tumour |
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R Malik, VK Pandya, S Parteki
Department of Radiodiagnosis & Imaging, Gandhi Medical College & Associated Hamidia Hospital, Bhopal, India
Click here for correspondence address and email
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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 |
 Case Report | |  |
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 | | |
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 | | |
| 1. | Win T, Lewin JS. Imaging characteristics of carotid body tumors. Am J Otolaryngol 1995 Sep-Oct; 16(5) : 325-8.  |
| 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. |
| 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. |
| 4. | Chambers, R. G. and Mahoney, W.D. : Carotid body tumours, Amer. J. Surg., 116:554-558, 1968. |
| 5. | Conley, J.M. : Management of carotid body tumours, Surg., Gynec. And Obstet., 117:722-732, 1963. |
| 6. | Harwell, W. : Carotid body tumours, Surgery., 59:483-493, 1966. |
| 7. | Batsakis, J.G. : "Tumours of Head of Neok", Williams and Wilkins Co., Baltimore, 1974, Chapter 19, pp. 280-287. |
| 8. | Howell, A., Monasterio, J. and Stuteville, O., Chemodectomas of the head and neck, Surg. Clin. North. Amer., 53: 175-177, 1973. |
Correspondence Address:
R Malik
Department of Radiodiagnosis & Imaging, Gandhi Medical College & Associated Hamidia Hospital, Bhopal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-3026.29147
Figures
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7] |
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