Functional intercarotid paraganglioma

摘要

The authors present the case history as well as laboratory, radiological, and pathologic findings of the current case. Relevant reports from the literature are reviewed. A 65-year-old woman with chronic hypertension presented with nasal congestion and was found to have a mass narrowing her oropharynx and hypo-pharynx. Computed tomography showed a tumor arising at the bifurcation of the carotid artery. Her 24-hour urine collection showed elevated metanephrines. The patient was managed preoperatively with phenoxybenzamine and atenolol. Arteriography revealed a highly vascular tumor with vascular feeding from a branch of the external carotid artery. Embolectomy was performed 48 hours later by surgical removal and was without complications. Subsequently, urinary metanephrine levels normalized but hypertension remained. Intercarotid paragangliomas occasionally produce an excess of circulating catecholamines but otherwise are clinically silent. A low threshold to rule out this possibility should exist duringthe evaluation of intercarotid paragangliomas.