PMC5717474_01
Carotid angiography image revealing a giant highly vascular, left-sided carotid body tumor.
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The patient then underwent a CT angiography, which revealed a well-defined large (> 8 cm) heterogeneous and hyperdense soft tissue lesion; showing intense arterial enhancement at the level of carotid bifurcation ( Figure 1).
Angiographic image revealing encasement of the common carotid as well as both of its main branches by the tumor.
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It was causing significant compression and displacement of a long segment of the internal carotid artery (ICA) and external carotid artery (ECA), encasing a broad area of the ICA and ECA ( Shamblin Grade 3) ( Figure 2).
Tumor having vascular supply from both the external and internal carotid arteries.
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The lesion was getting vascular supply from both the ICA and ECA branches ( Figure 3).
Surgical steps carried out during caudocranial subadventitial dissection.
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After ensuring temporary carotid control with vascular loops, sub-adventitial dissection of the lesion was carried out starting from the common carotid caudally and then progressing cranially towards the bifurcation and its branches ( Figure 4).
Cut specimen of the excised tumor, along with the characteristic Zellballen pattern in the histology.
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The histology from the lesion revealed a characteristic Zellballen pattern, highly suggestive of a Paraganglioma ( Figure 5).