Contemporary presentation and evolution of management of neck paragangliomas

Computerized tomographic scan with axial slices (left side) and sagittal reconstructions (right side) of a large right-side carotid body tumor extending to the level of the C1 vertebra.

Magnetic resonance imaging scan of a patient with bilateral carotid body tumors.

a. Diagnostic preoperative right carotid artery angiogram of the patient with the carotid body tumor shown in Fig 1, which demonstrates a hypervascular tumor, splaying the carotid bifurcation. b. Appearance following tumor embolization/coiling with significantly reduced vascularity.

Excision of a Shamblin group 1 carotid body tumor.

Flow chart of diagnostic modalities and adjunctive techniques recommended to improve safety of neck paraganglioma resection.

Excision of a Shamblin group 3 carotid body tumor that necessitated en-bloc tumor and carotid bifurcation excision followed by an interposition (common to internal carotid artery) saphenous vein bypass to replace the encased carotid artery.