Fine needle aspiration diagnosis of carotid body tumor in a case of multiple paragangliomas presenting with facial palsy: a case report.
BACKGROUND
Carotid body tumors (CBTs) constitute the most common extraadrenal paragangliomas. Many lesions diagnosed as CBTs by fine needle aspiration (FNA) cytology are clinically unsuspected. The main differential diagnosis is a thyroid neoplasm. The location of the mass in the lateral neck with prolonged history, hemorrhagic FNA and cytologic features resembling the endocrine neoplasm help in arriving at a suggestive diagnosis of paraganglioma.


METHODS
A 32-year-old male presented with left-sided facial palsy and swelling in the left side of the neck of 8 months' duration. The FNA sample was hemorrhagic and showed loosely arranged groups and acini formed by round to oval cells. A diagnosis of CBT was suggested. It was supplemented by additional noninvasive methods, such as ultrasonography of the neck region with color Doppler, computed tomography and magnetic resonance imaging of the brain, which also revealed a neoplasm suggestive of carotid body tumor in the right side of the neck and neoplastic lesion in the left cerebellopontine angle, suggestive of paraganglioma.


CONCLUSIONS
FNA, with the other noninvasive radiologic investigations, plays an important role in the diagnosis of CBT. We present this case of multiple paragangliomas for its unusual presentation and FNA diagnosis.
Naniwadekar
Manjiri R
MR
Department of Pathology, Krishna Institute of Medical Sciences, University, Karad, Maharashtra, India. man_nan@rediffmail.com
Jagtap
Sunil Vitthalrao
SV
Kshirsagar
Ashok Y
AY
Shinagare
Shweta A
SA
Tata
Hoshedar Ramyar
HR
Sahoo
Kulamani
K
D000328:Adult; D044963:Biopsy, Fine-Needle; D001932:Brain Neoplasms / Q000175:diagnosis*; D002345:Carotid Body Tumor / Q000150:complications / Q000175:diagnosis*; D005158:Facial Paralysis / Q000175:diagnosis* / Q000209:etiology; D006258:Head and Neck Neoplasms / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009378:Neoplasms, Multiple Primary; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color