RESUMEN
We present a biopsy proven case of 47 years-old man with a carotid pseudotumor, clinically presented as carotidynia. CT showed a mass encasing and narrowing the common carotid artery and MRI showed hypointense signal in T2 and intense enhancement after contrast media administration. The patient was suspected to have an inflammatory process and steroids were prescribed. Eight days after the steroid treatment significant radiological and clinical improvement was observed. The patient remains free of symptoms.
Apresentamos um caso comprovado por biópsia de pseudotumor carotídeo em um homem de 47 anos, com apresentação clínica de carotidinia. A TC mostrou massa envolvendo e estenosando a artéria carótida comum direita e a RM apresentava lesão com hipossinal em T2 e importante realce com o uso de meio de contraste paramagnético. O paciente recebeu a hipótese de lesão inflamatória e um tratamento com corticosteróides foi iniciado. Após oito dias de tratamento uma melhora clínica e radiológica significativas foram observadas. O paciente permanece assintomático.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Enfermedades de las Arterias Carótidas/diagnóstico , Arteria Carótida Común/patología , Granuloma de Células Plasmáticas/diagnóstico , Biopsia , Enfermedades de las Arterias Carótidas/patología , Enfermedades de las Arterias Carótidas/cirugía , Diagnóstico Diferencial , Granuloma de Células Plasmáticas/patología , Granuloma de Células Plasmáticas/cirugía , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
Carotidynia is defined as an atypical craniofacial pain syndrome caused by the dilatation or distension of the extracranial arteries. We report an unusual case of carotidynia mimicking trigeminal neuralgia caused by an arterioscle-rotic tortous carotid artery. A 68-year-old woman suffered from frequent episodes of severe electrical shock-like radiating pain around her left ophthalmic and maxillary division of the trigeminal nerve for 5 years. Initially, under the impression of trigeminal neuralgia, carbamazepine was tried. She was reevaluated due to an unsatisfactory pharmacological response. On examination, no abnormalities were found on the craniofacial region except for a tortous pulsating tender mass on the region of the left carotid artery. Routine laboratory findings and a connective tissue study were normal. Neck sonography and a 4-vessel angiography showed a tortous left internal carotid artery with stenosis extending near to the skin. The patient was treated for 2 weeks with a nonsteroidal anti-inflammatory agent, steroids, a prophylctic beta blocker, and a TCA antidepressant. The pain gradually subsided.