Where is the lesion?
Left carotid sheath posterior to the carotid bulb, internal, and external carotid arteries.
How does it look like?
Large oval avidly enhancing lesion displacing the carotid bifurcation anteriorly.
What is the differential diagnosis?
– Carotid bulb paraganglioma: avidly enhancing lesion with characteristic splaying of the internal and external carotid arteries (lyre sign).
– Glomus vagale: paragangliomas but of the vagus nerve, located posterior to the carotid arteries displacing them anteriorly.
– Vagal schwannoma: those that arises within the carotid sheath posteriorly but usually shows moderate enhancement compared with the avid enhancement of the paragangliomas.
What is the most likely diagnosis