Presentation
Pulsatile mass in the neck
Patient Data
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There is widening of the right carotid bifurcation with an extremely hypervascular carotid body tumor.
Lyre sign: splaying of the external and internal carotid arteries by the carotid body tumor.
Case Discussion
Biopsy is not available because the patient refuses. Nevertheless the imaging correspond to this type of tumor: homogenous, with subsequent posterior displacement of internal carotid and anterior displacement of the external carotid and high uptake of contrast medium.
Differential diagnoses could be: glomus jugulare tumor, arteriovenous malformations or hemangioma.
Carotid body are the most common paragangliomas of head and neck. Most of these tumors are benign with a small malignant potential. Although newer non-invasive diagnostic modalities have significantly enhanced the diagnostic compatibilities, controversy exists over adequate management of these rare tumors.
In younger, healthy patients with no comorbidities, the best therapeutic strategy is a complete excision of the tumor. However, in less than ideal patient population modalities such as radiation and tumor embolization can be considered.
Surgical advances have greatly decreased the mortality rates.