Vascular: Carotid Body Tumor

Carotid Body Tumor

Basics

  • Also Known As:
    • Carotid Paraganglioma
    • Carotid Chemodectoma
    • Glomus Tumor
  • Most are Benign & Slow Growing But May Be Locally Aggressive
  • Most are Nonfunctional – But Can Potentially Secrete Catecholamines
  • Highly Vascular

Forms

  • Spontaneous – Most Common
  • Familial – More Frequently Bilateral or Present Earlier
  • Hyperplastic – More Common if Exposed to Prolonged Hypoxia (COPD or Living at High Altitudes)

Shamblin Classification

  • Group I: Small & Easily Dissected Off the Carotid Artery Walls
  • Group II: Larger, Partially Surround & More Adherent to the Carotid Artery Adventitia
  • Group III: Encase the Carotid Arteries with Intimate Adherence

Presentation

  • Asymptomatic Neck Mass – Most Common
  • “Fontaine Sign” (Laterally Mobile but Fixed Longitudinally – From Association with Artery)
  • Pain
  • Compressive Symptoms (Dysphagia, Hoarseness or Horner’s Syndrome)

Diagnosis

  • Dx: US or CTA/MRA
    • “Lyre Sign” Pathognomonic (Widened Bifurcation & Tumor Blush Between)
  • Do Not Bx – Due to Bleeding Risk

Treatment

  • Primary Tx: Surgical Resection
    • Keep to Periadventitial Plane if Able – Extension of Adventitia May Weaken Artery & Cause Hemorrhage
  • Consider Preoperative Angioembolization Prior if Large (> 4 cm)

Carotid Body Tumor 1

Carotid Body Tumor on CTA, “Lyre Sign” 1

References

  1. Galyfos G, Stamatatos I, Kerasidis S, Stefanidis I, Giannakakis S, Kastrisios G, Geropapas G, Papacharalampous G, Maltezos C. Multidisciplinary Management of Carotid Body Tumors in a Tertiary Urban Institution. Int J Vasc Med. 2015;2015:969372. (License: CC BY-4.0)
  2. Michałowska I, Lewczuk A, Ćwikła J, Prejbisz A, Swoboda-Rydz U, Furmanek MI, Szperl M, Januszewicz A, Pęczkowska M. Evaluation of Head and Neck Paragangliomas by Computed Tomography in Patients with Pheochromocytoma-Paraganglioma Syndromes. Pol J Radiol. 2016 Oct 31;81:510-518. (License: CC BY-NC-4.0)