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Of the paragangliomas of the carotid,

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sheath and carotid space,

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The carotid body tumor is the most common.

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This is a tumor that arises at the carotid

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bifurcation and actually will splay the internal

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carotid artery and the external carotid

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artery away from each other.

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This is a patient who presented with a left

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sided neck mass and in point of fact,

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these carotid body tumors usually present

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not with neurologic symptoms,

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but with just a neck mass that is palpable.

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And this was palpable associated with the carotid

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artery. So as we come down from above,

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we see that this was not an Aid study

0:43

that was done as a CTA or a CTV.

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We're seeing both the carotid and the jugular vein.

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Well-pacified.

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And here you can see that there is a mass which is

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separating the internal carotid artery located here.

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From the external carotid artery located anterior

1:03

immediately with a mass at the carotid bifurcation.

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This mass has heterogeneous density to it.

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It's enhancing as much as the internal and external

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carotid artery, so it is enhancing avidly.

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The jugular vein, as you can see,

1:20

is being squashed by this posterior laterally.

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And this is a relatively large tumor.

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If you were to do a plane of section

1:30

that was oblique sagittal,

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you'll be able to see that this is rising

1:35

right at the carotid bifurcation.

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You can get a little bit of a sense

1:39

of that on the right side.

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Here's the common carotid artery separating into

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the internal and external carotid artery.

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And similarly,

1:47

here we have the mass that is separating

1:50

the two and splaying the two.

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On our straight sagittal reconstruction,

1:57

you can see the carotid bifurcations right here.

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With the external and the internal and the mass

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sitting right at the crotch of

2:05

the carotid bifurcation.

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There is a small component which does extend

2:09

down to the common carotid artery,

2:12

which you see right along this posterior margin.

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And this is a pretty good-sized tumor.

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Frankly,

2:19

the presence of necrosis in this central aspect of

2:22

the tumor is highly unusual for the paragangliomas.

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They usually have so much vascularity

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that they do not get necrotic.

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No significant lymphatic nephathy associated with it.

2:34

You want to look for additional paragangliomas.

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There are familial syndromes

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of multiple paragangliomas.

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So if you have a carotid body tumor on the left,

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make sure you also look at the carotid body on the

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right and look at the carotid bifurcation and then

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look at the carotid cheese structures up at

2:56

the upper cervical region for a glomus.

3:00

Begali tumor and then follow up intracranially

3:03

watching the jugular vein to look for

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a glomus jugulari. In this case,

3:08

a solid left carotid body tumor which extends around

3:12

the internal and external carotid artery and also

3:15

involves a portion of the common

3:18

carotid artery on the left.