Chemodectoma
Pathology
- Chemodectoma
- Tumour of paraganglion cells of the carotid body located at the bifurcation of the common carotid artery
- Usually benign (locally invasive)
- Occasionally malignant with potential to metastasise to local lymph nodes
Approach
- As for neck examination
- Inspect
- Located in the anterior traiangle of the neck at the angle of the jaw
- (Be gentle when examining this area as pressure on carotid bifurcation can induce a vasovagal attack)
- Palpate
- Solid and firm
- Pulsatile but not expansile - may be due to transmitted pulsation from adjacent carotid arteries, overlying palpable external carotid artery, true expansile pulsation from soft or very vascular tumour
- May be bilateral
- Due to intimate relationship with carotid artery, can be moved from side to side but not up and down
Investigations for diagnosis
- Doppler USS
- Angiography - gold standard - shows hypervascular mass displacing the bifurcation of the carotid artieries
- CT / MRI to delineate extent of tumour
Treatment
- Surgical
- Excision (with preoperative embolisation if the tumour is large)
- Ultrasonic surgical dissection may also be used
- Radiotherapy
- For patients unfit for surgery
- Large tumours
