Nuri M M H, Abdul Hameed Siddiqui, Syed Afzal Ahmad.
Carotid body tumor.
Pak Armed Forces Med J Jan ;55(3):265-7.

A 29 year old soldier presented with one year history of a painless progressively enlarging lump in the right side of the neck with six months history of headaches. His systemic examination revealed raised blood pressure (180/110 mmHg) loud aortic component of the second heart sound and grade 1 hypertensive retinopathy. Examination of the neck revealed palpable mass in the right submandibular region at the level of hyoid bone anterior to sternocleidomastoid mobile from side to side. Twenty four hour urinary VMA was raised (33 Um/ 24 hours). Fine needle aspiration cytology was inconclusive. The ultrasound reported a normal thyroid gland and a well defined mass of mixed echogenicity lying in the bifurcation of the right common carotid artery. CT scan of the neck showed fairly well defined rounded soft tissue attenuation mass in the right sub-mandibular region. The interface between the mass and gland was distinct. It extended along the right side of neck up to the level of the upper part of the thyroid cartilage. Laterally the lesion lied in relation to the right sternocleidomastoid muscle. Right internal and external carotid arteries and internal jugular vein were not visualized throughout the length of the lesion and seemed to be displaced by the mass. Carotid angiography revealed classic widening of the carotid bifurcation by a well-defined tumour blush ("lyre sign"). Renal and coronary angiograms were also done and were normal.

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