A 48-year-old woman has a slowly enlarging, painless lump at the left carotid bifurcation present for two years. It is firm, pulsatile, transmits the carotid pulse, is mobile side to side but not vertically, and a bruit is audible over it. CT shows a richly vascular mass splaying the internal and external carotid arteries. What is the most likely diagnosis?

• A Carotid body paraganglioma ✓
• B Branchial cyst
• C Carotid artery aneurysm
• D Neurofibroma of the vagus nerve

Explanation

B carotid body tumour is a chemodectoma arising at the bifurcation, classically producing a pulsatile mass that splays the carotid fork, is mobile horizontally but fixed vertically because it encircles the vessels. Branchial cysts are non-pulsatile and fluctuant, vagal neurofibromas are not pulsatile and displace rather than splay the artery, and an aneurysm would be expansile rather than solidly firm with this imaging appearance.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.