Wednesday, September 26, 2012

Tumors Identified via Selective Catheterization of the External Carotid Artery

1. Juvenile nasopharyngeal angiofibroma:
  • young boys presenting with epistaxis 
  • vascular hamartoma
  • embolization is therapeutic
2. Carotid body paraganglioma:
  • found at the bifurcation of the carotid artery where they splay its internal and external branches
  • prolonged, intense tumor blush
  • resectability depends on angle between ICA and ECA
  • patients often left with hoarseness due to proximity of vagus nerve
  • preoperative embolization may be considered
3. Meningioma:
  • highly vascular extra-axial neoplasm 
  • core is supplied by branches of the ECA while periphery is supplied by the ICA
  • "spoke wheel" appearance on angiogram
  • resection is usually curative
  • large tumors may be embolized prior to resection

Pribram HFW. Selective catheterization of the external carotid artery. Radiology 1966;87:315-20.
Roberson GH, Price AC, Davis JM, et al. Therapeutic embolization of juvenile angiofibroma. AJR Am J Roentgenol 1979;133:657-63.
Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol 2009;3(4)303-6.
Wilson G, Weidner W, Hanafee W. The demonstration and diagnosis of meningiomas by selective catheter angiography. AJR Am J Roentgenol 1965;95(4):868-73.

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