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\def\makelabel##1{\upshape ##1}}% } {\end{list}\end{raggedright}} \newenvironment{specHead}[2]% {\vspace{20pt}\hrule\vspace{10pt}% \phantomsection\label{#1}\markright{#2}% \pdfbookmark[2]{#2}{#1}% \hspace{-0.75in}{\bfseries\fontsize{16pt}{18pt}\selectfont#2}% }{} \def\TheFullDate{2014-01-15 (revised: 15 January 2014)} \def\TheID{\makeatother } \def\TheDate{2014-01-15} \title{Multi Detector 3D Computed Tomography in the Diagnosis of Paraganglioma: A Case Report} \author{}\makeatletter \makeatletter \newcommand*{\cleartoleftpage}{% \clearpage \if@twoside \ifodd\c@page \hbox{}\newpage \if@twocolumn \hbox{}\newpage \fi \fi \fi } \makeatother \makeatletter \thispagestyle{empty} \markright{\@title}\markboth{\@title}{\@author} \renewcommand\small{\@setfontsize\small{9pt}{11pt}\abovedisplayskip 8.5\p@ plus3\p@ minus4\p@ \belowdisplayskip \abovedisplayskip \abovedisplayshortskip \z@ plus2\p@ \belowdisplayshortskip 4\p@ plus2\p@ minus2\p@ \def\@listi{\leftmargin\leftmargini \topsep 2\p@ plus1\p@ minus1\p@ \parsep 2\p@ plus\p@ minus\p@ \itemsep 1pt} } \makeatother \fvset{frame=single,numberblanklines=false,xleftmargin=5mm,xrightmargin=5mm} \fancyhf{} \setlength{\headheight}{14pt} \fancyhead[LE]{\bfseries\leftmark} \fancyhead[RO]{\bfseries\rightmark} \fancyfoot[RO]{} \fancyfoot[CO]{\thepage} \fancyfoot[LO]{\TheID} \fancyfoot[LE]{} \fancyfoot[CE]{\thepage} \fancyfoot[RE]{\TheID} \hypersetup{citebordercolor=0.75 0.75 0.75,linkbordercolor=0.75 0.75 0.75,urlbordercolor=0.75 0.75 0.75,bookmarksnumbered=true} \fancypagestyle{plain}{\fancyhead{}\renewcommand{\headrulewidth}{0pt}} \date{} \usepackage{authblk} \providecommand{\keywords}[1] { \footnotesize \textbf{\textit{Index terms---}} #1 } \usepackage{graphicx,xcolor} \definecolor{GJBlue}{HTML}{273B81} \definecolor{GJLightBlue}{HTML}{0A9DD9} \definecolor{GJMediumGrey}{HTML}{6D6E70} \definecolor{GJLightGrey}{HTML}{929497} \renewenvironment{abstract}{% \setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Caroline Edward Ayad} \affil[1]{ Sudan University Of Science and Technology,College of Medical Radiological Science} \renewcommand\Authands{ and } \date{\small \em Received: 15 December 2013 Accepted: 4 January 2014 Published: 15 January 2014} \maketitle \begin{abstract} This report describes a case of 45-year-old female with carotid body paraganglioma.This study was conducted in May 2014. CT scanning was performed using high-resolution techniques. The 3D Volume-Rendering reconstructions provided a selective visualization of the anatomic relationships among carotid body tumors, vessels, and surrounding osseous structures with excellent details. Both tumors were suggested to be treated surgically with histological analysis. \end{abstract} \keywords{} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \let\tabcellsep& \section[{Introduction}]{Introduction}\par arotid body tumors are rare vascular neoplasms deriving from the paraganglionic cells of the carotid bifurcation. Incidence was reported to be 3.33 per 100,000 patients \hyperref[b16]{[Sajid MS, Hamilton G, Baker DM 2007}\hyperref[b13]{, Plukker JT et al, 2001]}. Females appear to be predominate [Rodriguez-Cuevas S 1998, Luna-Ortiz K et al, 2005]. The neoplasm presents as asymptomatic neck mass \hyperref[b4]{[Lazar B Davidovic et al, 2005]}.Total resection of the carotid body paragangliomas is the best and effective treatment although postoperative bleeding, stroke and injury to cranial nerves may accompany total resection \hyperref[b17]{[Young NM et al ,1988]}. \section[{II.}]{II.} \section[{Case Report}]{Case Report}\par A 45 year old female was referred from Eastern Sudan to the CT department with mass in her neck with pain; difficulty in swallowing. Her past medical history reported previous medications of hypertension and no family history of Paraganglioma. Physical examination showed a palpable mass, and no nerve problems were detected. CT with contrast and reconstructed Images were obtained (figure1) and showed hyper vascular mass (45x43x35 mm) which was seen at the bifurcation of left common carotid artery which was displaced laterally in addition to internal and external carotid arteries. Another smaller hyper vascular lesion (28x24x19mm) was seen at bifurcation of right common carotid artery showing similar imaging characteristics. No evident encasement of ICA or ECA.\par The lesion imaging features were consistent with bilateral carotid body tumors (paragangiliomas) III. \section[{Discussion}]{Discussion}\par The paraganglia was the most appropriate nomenclature from an embryologic point of view {\ref [Myers EN, Johnson JT, 1993} CT scanning was performed using a highresolution technique, slice thickness 0.5 mm. After acquisition, CT images were transferred to the workstation, oblique Maximum Intensity Projection (MIP) 12.50, WW/WL332/130 and Volume-Rendering images were generated (Vitrea 2, Vital Images). Multi-slice CT angiography demonstrated large and small masses within left carotid bifurcation. The 3D Volume-Rendering reconstructions provided a selective visualization of the anatomic relationships among carotid body tumors, vessels, and surrounding osseous structures with excellent details. Both tumors were suggested to be treated surgically with histological analysis.\par The carotid body was first described in 1743 \hyperref[b8]{[Milewski C, 1993]} .Carotid body tumors are rare vascular neoplasms originating in the paraganglionic cells of the carotid bifurcation. Their incidence ranges between 0.06-3.33 per 100,000 patients {\ref [Sajid MS, Hamilton G, Baker DM,2007} {\ref , Plukker JT et al, 2007]}.The carotid body paraganglioma is more common in females {\ref [ Maves MD,1993}] like the patient under study.\par [ {\ref Defraigne JO et al, 1997, Devuyever D et al1993]}. Radio immune detection of carotid body paraganglioma was also depicted in the previous studies \hyperref[b1]{[Devuyever D, 1993]}.\par The surgical removal is the treatment of choice for carotid body paragangliomas[ Rush Bf Jr1962].\par Multislice CT angiography can demonstrate a large, carotid body tumor, as well as small, unsuspected mass within the carotid bifurcation. The 3D volumerendering reconstructions provide a selective visualization of the anatomic relationships among carotid body tumors, vessels, and surrounding osseous structures with excellent detail. The diagnosis of this case was derived from the above mentioned facts. \begin{figure}[htbp] \noindent\textbf{}\includegraphics[]{image-2.png} \caption{\label{fig_0}D}\end{figure} \begin{figure}[htbp] \noindent\textbf{2}\includegraphics[]{image-3.png} \caption{\label{fig_1}Figure 2 :}\end{figure} \backmatter \begin{bibitemlist}{1} \bibitem[Sajid et al. ()]{b16}\label{b16} ‘A multi centre review of carotid body tumors management’. M S Sajid , G Hamilton , D M Baker . \textit{Eur J Vasc Endovasc Surg} 2007. 34 (2) p. . \bibitem[Pacheco-Ojeda et al. ()]{b12}\label{b12} ‘Carotid body tumors at high altitudes: Quito, Ecuador’. L Pacheco-Ojeda , E Durango , C Rodriquez . \textit{World J Surg} 1988. 12 p. . \bibitem[Rodriguez-Cuevas et al. ()]{b14}\label{b14} ‘Carotid body tumors in inhabitants of altitudes higher than 2000 meters above sea level’. S Rodriguez-Cuevas , J Lopez-Garza , S Labastidia-Almendaro . \textit{Head Neck} 1998. 20 (5) p. . \bibitem[Luna-Ortiz et al. ()]{b5}\label{b5} ‘Carotid body tumours: a review of a 20 year experience’. K Luna-Ortiz , M Rascon-Ortiz , V Villavicencio-Valencia , M Granados-Garcia , A Herrera-Gomez . \textit{Oral Oncol} 2005. 41 (1) p. . \bibitem[Lazar B Davidovic et al. ()]{b4}\label{b4} ‘Diagnosis and treatment of carotid body paraganglioma: 21 years of experience at a clinical center of’. Lazar B Davidovic , B Vojko , Djukic , M Dragan , Radomir P Sindjelicand Vasic , N Stevo , Duvnjak . 3:10. \textit{Serbia World Journal of Surgical Oncology} 2005. \bibitem[Muhm et al. ()]{b9}\label{b9} ‘Diagnostic and therapeutic approaches to carotid body tumors. Review of 24 patients’. M Muhm , P Polterauer , W Gsottner , A Temmel , B Richling , G Undt . \textit{Arch Surg} 1997. 132 (3) p. . \bibitem[Laube et al. ()]{b3}\label{b3} ‘Glomus tumors: A diagnostic and surgical challenge?’. H R Laube , A G Fahrenkamp , W Backer , H H Scheld . \textit{J Cardiol} 1994. 83 p. . \bibitem[Devuyever et al. ()]{b1}\label{b1} ‘Lateral neck paraganglioma:diagnostic imaging and preoperative embolization’. D Devuyever , P Mathurin , G Dooms , M Hamoir . \textit{J Belge Radiol} 1993. 76 p. . \bibitem[Defraigne et al.]{b0}\label{b0} ‘Limet R: Carotid chemodectomas. Experience with nine cases with reference to preoperative embolization and malignancy’. J O Defraigne , N Sakalihassan , P Antoine , A Thiry . \textit{Acta Chir Belg1997} 97 p. . \bibitem[Milewski ()]{b8}\label{b8} ‘Morphology and clinical aspects of paragangliomas in the area of head-neck’. C Milewski . \textit{HNO} 1993. 41 p. . \bibitem[Mosby Year Book ()]{b11}\label{b11} \textit{Mosby Year Book}, 1993. p. . \bibitem[Myers et al.]{b10}\label{b10} E N Myers , Jt: Johnson , ; Neoplasms , C W Cummings , J M Fredrickson , L A Harker , C J Krause , D E Schuller , St Louis . \textit{Otolaryngology-Head and Neck Surgery}, \bibitem[Plukker et al. ()]{b13}\label{b13} ‘Outcome of surgical treatment for carotid body paraganglioma’. J T Plukker , E P Brongers , A Vermey , A Krikke , J J Van Den Dungen . \textit{Br JSurg} 2001. 88 (10) p. . \bibitem[Kyriakos]{b2}\label{b2} ‘Pathology of selected soft tissue tumors of thehead and neck’. M Kyriakos . \textit{Comprehensive Management of Head and NeckTumors}, S E Thawley, W R Panje, Pa W B Philadelphia, Saunders (ed.) 1987 p. . \bibitem[Mayer et al. ()]{b7}\label{b7} ‘Radio therapy as adjunct to surgery for malignant carotid body paragangliomas presenting with lymph node metastases’. R Mayer , J Fruhwirth , A Beham , R Groell , J Poschauko , A Hackl . \textit{Strahlenther Onkol} 2000. 176 p. . \bibitem[Rush Bf Jr: Current concepts in the treatment of carotid body tumors Surgery ()]{b15}\label{b15} ‘Rush Bf Jr: Current concepts in the treatment of carotid body tumors’. \textit{Surgery} 1962. 52 p. 679. \bibitem[Young et al. ()]{b17}\label{b17} ‘Super selective embolization of glomus jugul are Tumors’. N M Young , R J Wiet , E J Russell , E M Monsell . \textit{Ann Otol Rhinol} 1988. 97 p. . \bibitem[Maves et al. ()]{b6}\label{b6} ‘Vascular tumors of the head and neck’. Md ; Maves , B J Bailey , J T Johnson , R I Kohut , H C Pillsbury , M E Tardy , Philadelphia , Lippincott . \textit{Head and Neck Surgery}, 1993. p. . \end{bibitemlist} \end{document}