Presentation
Left-sided neck painless swelling.
Patient Data
A partially circumscribed, homogenously enhancing mass lesion approximately measuring 3.5 x 3 x 4.3cm (AP x TR x CC) is noted involving left sided carotid bifurcation, the lesion is causing splaying of internal and external carotid arteries and encasing these arteries more than 180 degrees.
Anteriorly the lesion is abutting medial pterygoid muscle and postero-laterally exerting mass effect on ipsilateral internal jugular vein resulting in luminal narrowing and abutting ipsilateral sternocleidomastoid muscle.
Few, sub-centimetric lymph nodes noted in bilateral submandibular region, largest one with short axis measuring 8mm is noted in right submandibular region.
Left sided submandibular gland is not visualized (could be congenitally absent/agenesis).
Case Discussion
Current CT imaging features with typical location of the lesion are in favor of carotid body tumor as described above. Differential diagnosis could be a vagal schwannoma.