Friday, April 21, 2017

General

  • Also known as carotid body tumor, chemodectoma, and non-chromaffin paraganglioma
  • A benign vascular tumor originating from glomus bodies in the carotid body at the common carotid bifurcation (Hoang et al. 2019)

Paragangliomas

  • Paragangliomas are tumors of neuroendocrine cells associated with the sympathetic or parasympathetic nervous system
  • Types of paragangliomas include: carotid body tumors, glomus jugulare tumors, glomus tympanicum tumors, and glomus vagale tumors all within the head and neck, as well as pheochromocytomas
  • The majority are solitary, but if multiple paragangliomas are present, consider MEN 2a or MEN 2b (Ikram and Rehman 2022)
  • Paragangliomas are benign but locally invasive and highly vascularized

Radiologic Findings

  •  Look for splaying of the ECA anteromedially and the ICA posterolaterally
  • Found in the carotid space just above the hyoid bone in the crotch of the carotid bifurcation
  • Size at presentation is typically 1-6 cm with an ovoid, lobular appearance
  • On CT: splaying of ECA and ICA and density like that of muscle without contrast, avidly enhancing mass extending 
  • with contrast
  • On MR: "pepper" (black dots) and "salt" appearance (white dots - uncommon) on T1, hyperintense and good spread definition on post-contrast T1
  • Most commonly seen in patients in their 40s and 50s
CT with Contrast
CBPara_CT_0721

 

CT Angiography
CBPara_CTA_0721

References

Hoang VT, Trinh CT, Lai TAK, Doan DT, Tran TTT. Carotid body tumor: a case report and literature review. J Radiol Case Rep. 2019;13(8):19-30. Published 2019 Aug 31. doi:10.3941/jrcr.v13i8.3681

Ikram A, Rehman A. Paraganglioma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 5, 2022.