(Ultrasound Review) - This study from the Journal of Ultrasound in Medicine describes the ultrasound characteristics of carotid body tumors in six patients. "Carotid body tumors, also called chemodectomas, are a subtype of extraadrenal paraganglioma," according to the study. "They are slow-growing, usually benign tumors with malignancy occurring in about 6% of tumors."
During carotid artery duplex ultrasound they may be shown splaying the internal carotid artery (ICA) and the external carotid artery (ECA). Surgical removal can be a difficult procedure; the tumors are hypervascular and in close proximity to major vessels.
Patients presented with a swelling or non-tender mass below the angle of the mandible in the antero-lateral aspect of the neck. Ultrasound of the region demonstrated a well-circumscribed, solid, slightly hyperechoic homogenous mass at the carotid bifurcation.
Power Doppler has known advantages over color Doppler for certain situations. Its angle independence and good sensitivity to low flow in small vessels make it the preferred method for these tumors. Using power Doppler, the entire tumor demonstrated a characteristic hypervascular pattern, and pulsed Doppler showed a low resistance waveform.
The size of the lesions ranged from 2-6 cm. Other explanations for this type of swelling include enlarged lymph nodes, aneurysm of the carotid artery, branchial cleft cyst, neurogenic tumor, and salivary gland mass. The defining characteristics for carotid body tumors are location at the bifurcation causing displacement of the ICA and ECA, and the abundant vascular flow on power Doppler.
The researchers conclude that ultrasound incorporating power Doppler is the best imaging modality for these tumors, and that CT, MRI, and digital subtraction angiography (DSA) are not necessary. Ultrasound is inexpensive and noninvasive, and provides the information necessary to make an accurate diagnosis. DSA may be useful for tumor embolization prior to surgery.
J Ultrasound Med 2000; 19:367–370
H Arslan et al
YYU Tip Fakültesi, Radyoloji Anabilim Dah, Maras cad, 65200, Van, Turkey
By Ultrasound Review
September 28, 2000
Copyright © 2000 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
