Left carotid body paraganglioma

Case contributed by Maxime St-Amant


Suspicion of a left cervical mass.

Patient Data

Age: 75 years
Gender: Male

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

The most probable diagnosis is a carotid body paraganglioma (carotid glomus tumor / chemodectoma)

MRI TOF revealed the enhancing left carotid bifurcation lesion, splaying each of carotid artery branches.

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 hypervascular
  • glomus vagale tumor: same pathology but located more rostrally
  • carotid bulb ectasia

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.