Cavernous hemangioma of the carotid sheath

Slow-Flow Venous Vascular Malformation in the Carotid Sheath

Slow-flow venous vascular malformation is a benign lesion characterized by an abnormal but non-cancerous growth of capillaries. In the carotid space, a slow-flow venous vascular malformation is an exceptionally uncommon occurrence. Here, we present the case of a 58-year-old man who had been experiencing a slow-growing lump on the left side of his neck for the past four years. Upon conducting magnetic resonance imaging (MRI) of the neck soft tissues and computed tomography angiography (CTA) of the neck, imaging findings revealed a venous vascular malformation within the carotid sheath. Venous vascular malformation in the carotid space is rarely reported in the medical literature. The unique imaging findings for venous vascular malformation make our case distinct, which deviates from the more common entities usually encountered in this area, such as schwannoma or carotid body tumor. The atypical presentation of this case has brought about greater awareness among the medical community and readers alike.

A Vascular Malformation in the Carotid Sheath at the Carotid Bifurcation Mimicking Carotid Body Tumor

BACKGROUND

The carotid sheath contains clinically important and vital anatomical neurogenic, vascular, and lymphatic structures that allow for a great variety of lesions. Vascular anomalies found in the carotid sheath are rarely reported and may be easily misdiagnosed as arterial aneurysms, neurogenic tumors, paragangliomas, or lymphatic masses.

METHOD

We present a 60-year-old woman with a vascular malformation arising within the carotid sheath at the right carotid bifurcation, which mimics carotid body tumor.

RESULT

The mass was excised successfully with an uneventful postoperative course, and histological analysis suggested a vascular malformation with thin-walled blood vessels, lined by endothelial cells and separated by fibrous tissue. The patient was in good clinical condition without signs of relapse of the mass at 6-month follow-up.

CONCLUSION

Vascular malformation is a rare but existing possibility of pathology in the carotid sheath, which can be effectively removed by meticulous surgery.