K.E.M.
Radiology
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Department of Radiology
Seth G.S. Medical College and K.E.M. Hospital, Mumbai , India
Case of the Month
Carotid body paraganglioma
Contributed by: Pradeep H V Reddy
Clinical Profile:
A 45 year old woman came with the complaints of a swelling over right side neck associated with difficulty in swallowing since six months . The patient also had history of hoarseness of voice since two months. She gave history of palpitations and sweating on and off. During this period, the patient gave history of increased BP readings.
Fig. 1 Firm swelling was seen on the right side of neck.
Radiological findings:
The sonogram of the neck shows an heterogeneously hypoechoic lesion in the right side of neck between the right ICA and ECA at the bifurcation of right common carotid artery. There is extensive vascularity within the lesion.
Fig. 2 The sonogram of the neck shows heterogeneously hypoechoic lesion in the right side of neck at the bifurcation of right ICA and ECA. There is extensive vascularity seen within the lesion.
CECT of the neck (Fig 3) shows a well defined, ovoid, homogeneously enhancing soft tissue density lesion involving the right carotid space. The lesion splays the internal and external carotid artery arteries with lateral displacement of styloid process.
Fig. 3 : Axial and sagittal sections of the CT scan of the neck and brain shows a well defined, ovoid, homogeneously enhancing soft tissue lesion involving right carotid space measuring approximately 4.5x3.9x4.6cm. The lesionsplays the right internal and external carotid arteries with lateral displacement of right styloid process.
A four angiogram followed by embolisation was performed. (Fig 4)
Fig. 4 The right ECA injection shows feeding vessels from muscular branches of right ECA and predominently from the ascending pharyngeal artery ,Post embolization (right) of the ascending pharyngeal artery, they is minimal blush seen in the tumour
Radiological diagnosis:
Carotid body tumor
Figure 5: Post operative photograph of the tumour mass show the tumour measuring 2.9x3.8cm in its width and length respectively.
Figure 6: Histopathology of the tumour shows eosinophilic finely granular cytoplasm giving salt and pepper appearance