A 33-year-old man with a family history of multiple paragangliomas and a palpable left neck mass. A 33-year-old man with a family history of multiple paragangliomas.

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Embolization in the External Carotid Artery

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Presentation transcript:

A 33-year-old man with a family history of multiple paragangliomas and a palpable left neck mass. A 33-year-old man with a family history of multiple paragangliomas and a palpable left neck mass. Preoperative embolization was planned before resection of the left carotid body tumor. A, Volume-rendered reconstruction of a CTA of the neck shows bilateral carotid body tumors as well as 2 other glomus tumors along the left carotid sheath (arrows). B, Lateral view of the left common carotid angiogram reveals a large carotid body tumor supplied by multiple external carotid branches and splaying the ICA and ECA. C, After transarterial embolization of the occipital and ascending pharyngeal contributions to the tumor, residual tumor blush is noted. The vessels that remain are too small to be catheterized with a microcatheter (arrows). D, Fluoroscopic puncture of the tumor performed with an 18-gauge needle (arrowhead) and tumor embolized percutaneously by using a 30% mixture of n-BCA glue and ethiodol oil (arrows). E, Postembolization angiogram reveals near-complete devascularization of the carotid body tumor. F, Intraoperative photograph shows the exposed carotid body tumor. Intraoperative bleeding was <130 mL for the entire procedure. G, The cut surface of the excised specimen shows grossly a thrombosed tumor. D. Gandhi et al. AJNR Am J Neuroradiol 2008;29:1806-1815 ©2008 by American Society of Neuroradiology