Left carotid body paraganglioma

Case contributed by Dr Maxime St-Amant

Presentation

Suspicion of a left cervical mass.

Patient Data

Age: 75
Gender: Male
MRI

MRI shows a round lesion located between the internal and external carotid bifurcation, iso-intense to muscle on T1 (salt & pepper apperance) & T2, and enhancing avidly after gadolinium administration. The internal and external carotid arteries are splayed by the lesion.

The most probably diagnosis is a carotid body paranganglioma (or carotid glomus tumor, chemodectoma, 

MRI

Case Discussion

The differential diagnosis is quite limited in this case, as there is a classic salt & pepper appearance of the lesion on T1 weighted-images and splaying of the ICA / ECA. This is almost pathognomonic of carotid body paraganglioma.

The differential diagnosis for a tumor in this location includes :

  • vagal schwannoma : tends to displace both vessels together rather than splaying them
  • vagal neurofibroma : tends to displace both vessels together rather than splaying them
  • lymph node mass : may look similar if hyper-vascular
  • glomus vagale tumour : same pathology but located more rostrally
  • carotid bulb ectasia
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Case information

rID: 19255
Case created: 21st Aug 2012
Last edited: 18th May 2017
Inclusion in quiz mode: Included

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