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Interesting CaseCAROTID BODY TUMOR
TERESA WELLS, BHSA, RDMS, RVT, RT
NOVEMBER 11, 2014
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Anatomy and Function
Carotid Body (glomus) (1)
3-5 mm in the adventitia of the bifurcation of the
common carotid artery
Chemoreceptor
pH (acidity), pCO2 (Partial pressure of carbon dioxide), and pO2
(partial
pressure of oxygen)
Regulates cardiovascular and respiratory function
Increases blood pressure, heart rate, and respiratory rate
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Anatomy and Function
Carotid Body
(2)
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Carotid Body Tumors (4,5)
Most common paraganglioma
Peripheral nerve mass
Rare
Slow growing
10% malignancy
50-70 years of age
Females over males 2:1
Accidental findings
(3)
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Common signs and symptoms (3, 5, 6)
Neck mass
Hoarseness
Head ache
Partial paralysis or numbness in the tongue
Vision changes
High blood pressure or heart palpitations
Bruit
Compression of the extra-cranial vessels
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Patient history: Female, 63 yr. old.
2008 Carotid Duplex and MRA head aches
vision loss 2 minutes
No prior CVA
No cardiac history
No neck surgery
Not DM
Not smoker
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2008 Carotid Duplex: Small atheromatous plaque. No
hemodynamically
significant lesion.
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2008 Carotid Duplex:
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2008 MRA: Carotid bifurcations are essentially normal.
Minimal atherosclerotic disease..
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Patient history: Female, 68 yr old.
2013 Carotid Duplex Acute RT sided weakness
Visual disturbances
No prior CVA
No cardiac history
No neck surgery
Type II DM
Not smoker
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2013 Carotid Duplex:
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2013 Carotid Duplex:
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2013 Carotid Duplex:
7mm well circumscribed,
vascular nodule, splaying the
LT carotid bifurcation.
Minimal plaque
Recommend MRI
Differential: Carotid body
tumor/paraganglioma or
lymph node
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2008 2013
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2013 MRI: 8mm nodule within the LT carotid bifurcation with
subtle
enhancement. Differential: Carotid body
tumor/paraganglioma or lymph node. Consider CT.
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2013 CT:
8mm nodule within the LT
carotid bifurcation
Differential: Carotid body
tumor/paraganglioma or
lymph node.
Recommend short term
follow up
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US MRI CT
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US Non inflammatory lymph node would NOT be hyper-vascular
Inexpensive, non-invasive, readily available (7)
MRI Help distinguish from inflammation or hemorrhage
Flow voids can enhance with gadolinium (7)
CT Excellent for defining exact location of adjacent
structures
Distinguish congenital, inflammatory and neoplastic masses
(7)
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Differential Diagnosis (7)
Carotid body tumor
Paraganglioma
Lymphadenopathy
Lipoma
Thyroid or parathyroid adenoma
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Treatments (4, 6)
Surgically resection
Radiotherapy
Embolization
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Patient never returned for follow up
2008 2013
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References
1. Kumar, P., & Prabhakar, N. R. (2012). Peripheral
chemoreceptors: Function and plasticity of the carotid body.
Comprehensive Physiology, 2, 141–219.
2. Dorland's Medical Dictionary: para-aortic bodies. (n.d.)
Dorland's medical dictionary for health Consumers. (2007).
Retrieved November 13 2014 from
http://medical-dictionary.thefreedictionary.com/para-aortic+bodies
3. Hallett, J. (1988, Feb) Trends in neurovascular complications
of surgical management for carotid body and cervical
paragangliomas: A fifty-year experience with 153 tumors. Journal of
Vascular Surgery, 72.
4. Sajid, M., Hamilton, G., & Baker, D.M. (2007) A
multicenter review of carotid body tumourmanagement. European
Journal of Vascular Endovascular Surgery, 34, 127-130.
5. Wieneke J., & Smith, A. (2009) Paraganglioma: Carotid
body tumor. Journal of Head and Neck Pathology, 3, 303–306.
6. Ma, D., Liu, M., Yang, H., Ma, X., & Zhang, C. (n.d.)
Diagnosis and surgical treatment of carotid body tumor: A report of
18 cases. Journal of Cardiovascular Disease Research, 1.
7. Reeder, M.M. (2003) Gamuts in radiology: Comprehensive lists
of roentgen differential diagnosis, 4th ed. New York:
Springer-Verlag New York, Inc.
