EURORAD ESR

Case 13542

A rare case of laryngeal paraganglioma presenting as a neck mass

Author(s)
Arun Thomas, Rajendran V R, Saanida M P, Juvaina Faiz

Department of Radio-diagnosis,
Government medical college,
Calicut, Kerala, India
 
Patient
female, 40 year(s)
 
 
  • Figure 1
    USG
     

    USG showed an iso to hypoechoic lesion with well circumscribed borders on the left side of the neck.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Localisation; Special Focus: Neoplasia;

    The lesion is noted to extend through the thyrohyoid membrane into the larynx.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Localisation; Special Focus: Neoplasia;

    The lesion shows significant internal vascularity.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Localisation; Special Focus: Neoplasia;

    Low resistance flow pattern is noted within the lesion.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Localisation; Special Focus: Neoplasia;
     
     
  • Figure 2
    CT
     

    Non contrast axial CT section shows a mildly hypodense bilobed lesion with intra and extralaryngeal components

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Localisation; Special Focus: Neoplasia;

    Axial contrast CT section at the level of C4 vertebra shows an intensely enhancing bilobed lesion with intralaryngeal component in the pre-epiglottic fat and extralaryngeal extension through thyrohyoid membrane.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Localisation; Special Focus: Neoplasia;

    Coronal contrast CT section shows the bilobed enhancing lesion with intra and extralaryngeal components

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Localisation; Special Focus: Neoplasia;

    Sagittal CT section shows the extralaryngeal component of the lesion

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Localisation; Special Focus: Neoplasia;

    Sagittal CT section shows the intralaryngeal component of the lesion

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Localisation; Special Focus: Neoplasia;
     
     
  • Figure 3
    MRI
     

    Axial T1 section shows an isointense lesion with intra and extralaryngeal components.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Localisation; Special Focus: Neoplasia;

    Axial T2 section shows a hyperintense lesion containing a few flow voids.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Localisation; Special Focus: Neoplasia;

    T1FatSat axial post contrast image shows intense enhancement of the lesion.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Localisation; Special Focus: Neoplasia;

    MRA image shows intense enhancement of the lesion with multiple adjacent feeding vessels

     
    Area of Interest: Head and neck; Imaging Technique: MR-Angiography; Procedure: Localisation; Special Focus: Neoplasia;
     
     
  • Figure 4
    Digital substraction angiography
     

    Early arterial phase shows intense tumour blush with supply from feeders arising from the left superior thyroid artery.

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;

    Tumour blush is intensified in late arterial phase.

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;

    Rapid washout is noted in early venous phase

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;

    Complete washout is noted in late venous phase.

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;

    No supply is noted from left vertebral artery.

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;

    No supply is noted from right common carotid artery

     
    Area of Interest: Head and neck; Imaging Technique: Catheter arteriography; Procedure: Catheters; Special Focus: Neoplasia;
     
     
USG showed an iso to hypoechoic lesion with well circumscribed borders on the left side of the neck.
 
The lesion is noted to extend through the thyrohyoid membrane into the larynx.
 
The lesion shows significant internal vascularity.
 
Low resistance flow pattern is noted within the lesion.
 
Non contrast axial CT section shows a mildly hypodense bilobed lesion with intra and extralaryngeal components
 
Axial contrast CT section at the level of C4 vertebra shows an intensely enhancing bilobed lesion with intralaryngeal component in the pre-epiglottic fat and extralaryngeal extension through thyrohyoid membrane.
 
Coronal contrast CT section shows the bilobed enhancing lesion with intra and extralaryngeal components
 
Sagittal CT section shows the extralaryngeal component of the lesion
 
Sagittal CT section shows the intralaryngeal component of the lesion
 
Axial T1 section shows an isointense lesion with intra and extralaryngeal components.
 
Axial T2 section shows a hyperintense lesion containing a few flow voids.
 
T1FatSat axial post contrast image shows intense enhancement of the lesion.
 
MRA image shows intense enhancement of the lesion with multiple adjacent feeding vessels
 
Early arterial phase shows intense tumour blush with supply from feeders arising from the left superior thyroid artery.
 
Tumour blush is intensified in late arterial phase.
 
Rapid washout is noted in early venous phase
 
Complete washout is noted in late venous phase.
 
No supply is noted from left vertebral artery.
 
No supply is noted from right common carotid artery
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version