Senapati Sidhartha G, Kattamuri Lakshmi, Deoker Abhizith
Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Cureus. 2024 Dec 4;16(12):e75074. doi: 10.7759/cureus.75074. eCollection 2024 Dec.
Carotid body tumors (CBTs), rare neuroendocrine neoplasms near the carotid bifurcation, are mostly asymptomatic but may cause discomfort and autonomic dysfunction. Computed tomography angiography (CTA) is used for diagnosis, eliminating the need for a biopsy to avoid the risk of hemorrhage. Surgical excision is the preferred treatment, while radiotherapy is an option when surgery is impractical. A 75-year-old woman with diabetes and hypertension presented to the emergency room (ER) with nausea, vomiting, and severe headache. Her blood pressure was 196/134 mmHg, her heart rate was 140 beats per minute (bpm), and her electrocardiogram (EKG) showed atrial fibrillation (AF). Physical examination revealed elevated jugular venous pressure. Preliminary lab investigations were normal. CT of the head, followed by an MRI of the neck with and without contrast, showed a stable 38 x 53 x 15 mm mass in the left side of the neck consistent with carotid body paraganglioma. A hormonal workup indicated elevated metanephrines, ruling out adrenal tumors. An abdominal CT scan showed no adrenal tumors. Due to her age and comorbidities, radiotherapy was planned for the stable mass. This article discusses the diagnosis of a rare, slow-growing carotid body tumor that requires thorough assessment, including patient history and radiologic evaluation.
颈动脉体瘤（CBTs）是一种位于颈动脉分叉处附近的罕见神经内分泌肿瘤，大多无症状，但可能引起不适和自主神经功能障碍。计算机断层扫描血管造影（CTA）用于诊断，无需活检以避免出血风险。手术切除是首选治疗方法，而当手术不可行时，放射治疗是一种选择。一名患有糖尿病和高血压的75岁女性因恶心、呕吐和严重头痛就诊于急诊室（ER）。她的血压为196/134 mmHg，心率为每分钟140次（bpm），心电图（EKG）显示心房颤动（AF）。体格检查发现颈静脉压升高。初步实验室检查正常。头部CT检查，随后对颈部进行有对比剂和无对比剂的MRI检查，显示颈部左侧有一个大小为38×53×15 mm的稳定肿块，符合颈动脉体副神经节瘤。激素检查显示甲氧基肾上腺素升高，排除肾上腺肿瘤。腹部CT扫描未发现肾上腺肿瘤。由于她的年龄和合并症，计划对稳定的肿块进行放射治疗。本文讨论了一种罕见的、生长缓慢的颈动脉体瘤的诊断，该诊断需要进行全面评估，包括患者病史和影像学评估。
