Carotid Body Tumour Misdiagnosed as a Traumatic Carotid Pseudoaneurysm

Author(s): Harvey J, Boles B, Ipeson K

Blunt carotid injury that occurs as a result of near-hanging or strangulation carries a significant morbidity as a result of subsequent ischaemic stroke. Clinical examination is poorly predictive in identifying patients with vascular injuries and imaging plays a central role in screening these patients in the emergency setting. We present the case of young woman who presented to the emergency department following near-hanging. CT angiogram examination of the neck demonstrated an enhancing focus at the carotid bifurcation which was initially misidentified as a carotid artery pseudoaneurysm. Ultrasound demonstrated absence of flow within the mass which was interpreted as thrombosis of the pseudoaneurysm. Following an unsuccessful attempt at embolisation, the imaging was reviewed and the correct diagnosis of a carotid body tumour reached. Differentials for an enhancing mass within the carotid space include a pseudoaneurysm, carotid body tumour, enhancing lymph node, schwannoma or neurofibroma. General radiologists should be aware of the imaging distinctions between these carotid space pathologies.