Cervical ganglioneuroma mimicking a carotid body tumour

A 30-year-old woman was referred to the ear, nose and throat clinic by her primary care physician for a 10-year history of an asymptomatic, large, right-sided neck mass. On examination, the patient had a palpable, non-tender, five-by-four centimetre, mobile, right-sided level II neck mass. CT scan with intravenous contrast showed an enhancing mass with multiple fluid cavities, splaying the external carotid and internal carotid arteries, concerning for a carotid body tumour. Patient was then referred to interventional radiology for angiography and embolisation prior to definitive surgical excision. However, when the mass was then excised surgically, final pathology identified the mass as a ganglioneuroma. Patient recovered well postoperatively with some ptosis of the right eye and symptoms consistent with first bite syndrome, treated with conservative measures.

A rare case of Scwannoma at carotid space of neck region mimicking as Paraganglioma.

This is a case of carotid body tumour at right side of neck region with initially diagnosed as paraganglioma. A 22 year old female patient with an history of pain and swelling at right side of neck region with intermittent headache difficulty during deglutination. Patient has taken medication for pulmonary kochs for 8 months. Now presented with the mentioned complaints with a swelling at right side swelling at neck region. The features and the correlation with MRI report diagnosed as paraganglioma and then on Histopathologic examination showed a tumour mass composed of two different areas admixed with each other either alternatively or diffusely. The final pathological impression was Neurilemmoma (Schwannoma).The diagnosis was definitive with no evidence of paraganglioma.

Carotid body Tumour with Hypoglossal Nerve Palsy- A Case Report

Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of the right side involving the right hypoglossal nerve with MRI appearance and pathological features. The objective is to present a case of Hypoglossal nerve palsy due to carotid body tumour involving the right carotid artery bifurcation. Method: A 18-year old male presented with a welldefined swelling of his right neck, increasing hoarseness, and left ward tongue deviation on protrusion present for two years CT neck and MRI were done. The tumour was identified and the patient underwent surgery. His Histopathology report commented it to be carotid body tumour. Result: The patient showed significant improvement after surgery. His tongue deviation improved and his hoarseness of voice had been begun to improve. Conclusion: Carotid body tumours are benign lesion mimicking other pathology. High level of suspicision, imaging and careful resection is important for avoiding complications. Bangladesh Heart Journal 2019; 34(1) : 68-72

First-positive surveillance screening in an asymptomatic SDHA germline mutation carrier

Summary At least 40% of phaeochromocytomas and paraganglioma’s (PPGLs) are associated with an underlying genetic mutation. The understanding of the genetic landscape of these tumours has rapidly evolved, with 18 associated genes now identified. Among these, mutations in the subunits of succinate dehydrogenase complex (SDH) are the most common, causing around half of familial PPGL cases. Occurrence of PPGLs in carriers of SDHB, SDHC and SDHD subunit mutations has been long reported, but it is only recently that variants in the SDHA subunit have been linked to PPGL formation. Previously documented cases have, to our knowledge, only been found in isolated cases where pathogenic SDHA variants were identified retrospectively. We report the case of an asymptomatic suspected carotid body tumour found during surveillance screening in a 72-year-old female who is a known carrier of a germline SDHA pathogenic variant. To our knowledge, this is the first screen that detected PPGL found in a previously identified SDHA pathogenic variant carrier, during surveillance imaging. This finding supports the use of cascade genetic testing and surveillance screening in all carriers of a pathogenic SDHA variant. Learning points: SDH mutations are important causes of PPGL disease. SDHA is much rarer compared to SDHB and SDHD mutations. Pathogenicity and penetrance are yet to be fully determined in cases of SDHA-related PPGL. Surveillance screening should be used for SDHA PPGL cases to identify recurrence, metastasis or metachronous disease. Surveillance screening for SDH-related disease should be performed in identified carriers of a pathogenic SDHA variant.

Carotid body tumour in a dog: computed tomography and histopathology findings and evaluation of surgical management

A 2.5-kg, eight-year-old, neutered male Yorkshire Terrier was presented for evaluation of a cervical mass that had first been noticed a year earlier. A firm spherical mass located caudal to the left mandible was found on physical examination. Ultrasonography revealed a well-defined, round-shaped mass located medial to the left mandibular salivary gland that was approximately 2.6 cm in height, 2.3 cm in width and 3 cm in length. Volume-rendered images obtained by computed tomography (CT) showed that the left external and internal carotid arteries and internal jugular vein were encased in the mass. A definitive diagnosis of carotid body tumour was made based on histopathology. The tumour and the carotid arteries and internal jugular vein encased in the tumour were resected using CT-based surgical planning. The regional neural structures were preserved by careful blunt dissection. The dog had a mild hacking cough after swallowing and hoarseness that disappeared spontaneously five days and two months, respectively, after surgery. There was no evidence of recurrence or distant metastasis at 18 months postoperatively. This case report describes successful surgical management of a carotid body tumour with ligation and transection of the carotid arteries in a dog. To the authors’ knowledge, this is the first report of successful surgical treatment of an advanced carotid body tumour based on CT findings.

Carotid body tumour: an enigma that remains

<p class="abstract">Carotid body tumour is a form of paraganglioma which arises from the carotid body. This tumour is known for its rich vascular supply mainly contributed by the ascending pharyngeal artery, a branch from external carotid artery. Surgical excision preceded by pre-operatic embolization remains the definitive treatment despite the countless feared complications. We present our experience with a case of carotid body tumour which was embolised prior to surgical excision, unfortunately complicated with a thromboembolic event. This patient was found to have an anatomical variation in the cerebrovascular anatomy known as a fetal posterior cerebral artery which led to a paradoxical PCA infarction post-embolization. We would like to highlight this rare presentation along with its management as there were scarce evidence of this case in the literature.</p>