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Es ist ein Weilchen her …
Hier endlich ein neuer spannender Fall zum knobeln. Ihr könnt den Fall unter www.veheri.com/cases/1011329632 vollständig einsehen. Die Lösung gibt es in ca. 2 Wochen auf www.veheri.com. Bis dahin bin ich gespannt auf eure Ideen, hier oder auf veheri.

It's been a while...
Here's finally a new, exciting case to puzzle over. You can view the case in full at www.veheri.com/cases/1011329632. I'm excited to hear your ideas. The solution will be available in about 2 weeks at www.veheri.com. Until then I'm excited to hear your ideas, here or on veheri.



Radiological report:
A right sided, retropharyngeal large heterogenous mass is visible. The mass starts medial to the mandibular gland and extends dorsally towards the neurocranium. The mass infiltrates the digastric and medial pterygoid muscle. It causes moth eaten and permeative osteolysis of all parts of the temporal bone. Extension of the mass through the osteolysis into the neurocranium is visible, forming a superficial plaque like mass. Intracranially the mass extends from the level of the hypophyseal fossa to the osseous tentorium cerebelli. Extracranially the mass follows the carotid artery up to the level of the thyroid gland. The mass shows a strong, heterogenous contrast enhancement.

Radiological diagnosis:
Aggressive, soft tissue right retropharngeal mass in region of the carotid bifurcation

Diagnosis
Carotid body tumor / paraganglioma

Discussion
Carotid body tumor is a type of chemodectoma or paraganglioma. They arise from them chemoreceptors within the wall of the carotid artery at the level of the bifurcation of the common carotid artery. Brachycephalic dogs and boxers are predisposed, with a male predilection. Reported median age is 9 years. The tumor shows an invasive growth pattern and follows the internal carotid artery into the neurocranium. Clinical symptoms include palpable mass, respiratory problems, Horner`s Syndrome, swallowing problems, head tilt, etc.
The mass should not be confused with thyroid tumors or a mass of medial retropharyngeal lymphnode which appear and behave differently.
*Kromhout, K., Gielen, I., De Cock, H.E. et al. Magnetic resonance and computed tomography imaging of a carotid body tumor in a dog. Acta Vet Scand 54, 24 (2012). doi.org/10.1186/1751-0147-54-24
*Mai, Wilfried; Seiler, Gabriela S.; Lindl-bylicki, Britany J.; Zwingenberger, Allison L. (2015). CT AND MRI FEATURES OF CAROTID BODY PARAGANGLIOMAS IN 16 DOGS. Veterinary Radiology & Ultrasound, 56(4), 374–383. doi:10.1111/vru.12254

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Sebastian Ganz

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