Comprehensive management of carotid body paragangliomas: A case report on diagnosis, surgical resection, and postoperative surveillance

Abstract

Carotid body paragangliomas (CBPs) are rare, highly vascular neuroendocrine tumors arising at the carotid bifurcation and represent a diagnostic and therapeutic challenge because of their close anatomical relationship with major cervical vessels and cranial nerves. We report the case of a 45-year-old woman who presented with a slowly progressive, painless left lateral cervical mass evolving over a 10-month period. Multimodal imaging evaluation, including high-resolution cervical ultrasound, contrast-enhanced computed tomography, and digital subtraction angiography, demonstrated a well-defined hypervascular lesion at the carotid bifurcation with characteristic splaying of the internal and external carotid arteries, consistent with a Shamblin type II CBP. Biochemical investigations excluded functional tumor activity. The patient underwent complete surgical excision with preservation of the carotid arteries and adjacent cranial nerves. Postoperative imaging follow-up showed no evidence of local recurrence. This case highlights the pivotal role of high-quality multimodal imaging in establishing the diagnosis, guiding preoperative risk stratification and surgical planning, and ensuring effective postoperative surveillance in patients with CBPs.