0:01

This was an elderly gentleman who

0:03

had a right-sided neck mass.

0:06

There was a bruise overlying the neck mass, and let's

0:11

go scroll down and see what it looked like.

0:15

So we're going from above.

0:17

We're looking on the right side.

0:20

Because it's a brewery,

0:21

we want to follow the carotid sheath structures.

0:24

And we come here and we see lots of extra little

0:28

blood vessels around the right internal carotid

0:30

artery contrasted to the left internal

0:33

carotid artery. And as we go down,

0:36

we come into a mass which is between the right

0:42

internal carotid artery and the

0:44

external carotid artery.

0:45

Here we have the carotid bifurcation with a little

0:47

carotid atherosclerotic plaque. So common carotid artery,

0:52

carotid bifurcation,

0:54

internal external mass in between the internal

0:58

and external carotid artery.

1:00

It's involving less than 180 degrees

1:02

of the carotid circumference.

1:05

It's a mass that has lots of little blood vessels

1:07

flowing through it, and it's splaying the two.

1:11

And you can see that there is this hypervascular

1:14

nature to the mass. Given all this,

1:17

we would say it's very likely that

1:19

this is a carotid body tumor.

1:21

We next would want to look at the contralateral

1:23

carotid bifurcation,

1:25

make sure that there's not a mass there.

1:27

There is nothing enhancing there.

1:30

We want to follow the carotid upwards,

1:32

make sure that there's not an additional carotid

1:36

glomus jugulari or glomus vagale tumor.

1:39

There are none. And we have the mass.

1:43

The mass is also seen on the coronal scans.

1:46

Kind of wider than it is, AP tension.

1:50

And if we pull down the sagittal,

1:53

we can see its relationship to the

1:55

carotid bifurcation here,

1:57

the external carotid artery anteriorly.

2:00

Here's the internal carotid artery posteriorly,

2:04

sitting right at the carotid bifurcation notch.

2:07

Here we see the blood vessels supplying it.

2:09

The blood vessels supplying it are usually

2:10

the ascending pharyngeal arteries.

2:13

And this is a second right-sided carotid body tumor.