Carotid Body Tumor: Incidental Discovery and Diagnosis

Carotid body tumors (CBTs), rare neuroendocrine neoplasms near the carotid bifurcation, are mostly asymptomatic but may cause discomfort and autonomic dysfunction. Computed tomography angiography (CTA) is used for diagnosis, eliminating the need for a biopsy to avoid the risk of hemorrhage. Surgical excision is the preferred treatment, while radiotherapy is an option when surgery is impractical. A 75-year-old woman with diabetes and hypertension presented to the emergency room (ER) with nausea, vomiting, and severe headache. Her blood pressure was 196/134 mmHg, her heart rate was 140 beats per minute (bpm), and her electrocardiogram (EKG) showed atrial fibrillation (AF). Physical examination revealed elevated jugular venous pressure. Preliminary lab investigations were normal. CT of the head, followed by an MRI of the neck with and without contrast, showed a stable 38 x 53 x 15 mm mass in the left side of the neck consistent with carotid body paraganglioma. A hormonal workup indicated elevated metanephrines, ruling out adrenal tumors. An abdominal CT scan showed no adrenal tumors. Due to her age and comorbidities, radiotherapy was planned for the stable mass. This article discusses the diagnosis of a rare, slow-growing carotid body tumor that requires thorough assessment, including patient history and radiologic evaluation.