Cervical ganglioneuroma mimicking a carotid body tumour

A 30-year-old woman was referred to the ear, nose and throat clinic by her primary care physician for a 10-year history of an asymptomatic, large, right-sided neck mass. On examination, the patient had a palpable, non-tender, five-by-four centimetre, mobile, right-sided level II neck mass. CT scan with intravenous contrast showed an enhancing mass with multiple fluid cavities, splaying the external carotid and internal carotid arteries, concerning for a carotid body tumour. Patient was then referred to interventional radiology for angiography and embolisation prior to definitive surgical excision. However, when the mass was then excised surgically, final pathology identified the mass as a ganglioneuroma. Patient recovered well postoperatively with some ptosis of the right eye and symptoms consistent with first bite syndrome, treated with conservative measures.