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Carotid Body Paraganglioma

last modified on: Fri, 04/21/2017 - 14:19

  1.  General:
    1. Also known as carotid body tumor, chemodectoma, and non-chromaffin paraganglioma
    2.  A benign vascular tumor originating from glomus bodies in the carotid body at the common carotid bifurcation
  2. Paragangliomas:
    1. Paragangliomas are tumors of neuroendocrine cells associated with the sympathetic or parasympathetic nervous system

    2. 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

    3. The majority are solitary, but if multiple paragangliomas are present, consider MEN 2a or MEN 2b

    4. Paragangliomas are benign but locally invasive and highly vascularized
  3. Radiologic Findings (see below):
    1.  Look for splaying of the ECA anteromedially and the ICA posterolaterally
    2.  Found in the carotid space just above the hyoid bone in the crotch of the carotid bifurcation
    3.  Size at presentation is typically 1-6 cm with an ovoid, lobular appearance
    4.  On CT: splaying of ECA and ICA and density like that of muscle without contrast, avidly enhancing mass extending cephalad with contrast
    5.  On MR: "pepper" (black dots) and "salt" appearance (white dots - uncommon) on T1, hyperintense and good spread definitinon on post-contrast T1
    6.  Most commonly seen in patients in their 40s and 50s