Idiopathic inflammatory pseudotumor of the carotid sheath

Luciano Farage1, Ana Carolina B S da Motta, David Goldenberg

  • 1The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD, USA. lucianofarage@ig.com.br

Insights

A rare carotid pseudotumor was diagnosed in a 47-year-old man presenting with carotidynia. Steroid treatment led to significant clinical and radiological improvement, resolving symptoms.

Area of Science:

  • Vascular Surgery
  • Neuroradiology
  • Pathology

Background:

  • Carotid pseudotumor is a rare condition that can mimic other pathologies of the carotid artery.
  • Carotidynia, or pain in the neck over the carotid artery, can be a presenting symptom of carotid pseudotumor.

Observation:

  • A 47-year-old male presented with clinical symptoms of carotidynia.
  • Imaging revealed a mass encasing and narrowing the common carotid artery, with characteristic MRI signals suggesting an inflammatory process.
  • Biopsy confirmed the diagnosis of carotid pseudotumor.

Findings:

  • The patient received corticosteroid therapy based on the suspected inflammatory nature of the pseudotumor.
  • Within eight days of treatment, significant radiological and clinical improvements were observed.

Implications:

  • This case highlights the effectiveness of steroid treatment for symptomatic carotid pseudotumor.
  • Early diagnosis and appropriate management can lead to favorable patient outcomes and symptom resolution.