295 □ CASE REPORT □ Carotid Body Tumor as a Cause of Stroke Hrvoje Budin!evi" 1,2 , Ana Pirši" 1 , Tihana Bohm 1 , Tomislav Trajbar 3 , Ante Ivkoši" 3 , Tomislav Pavlovi" 4 , Ivan Bielen 1,2 and Silva Soldo-Butkovi" 2,5 Abstract We herein report a case of a 78-year-old woman who was admitted to our hospital due to a stroke with left-sided hemiparesis. Ultrasound of the carotid arteries showed a carotid body tumor on the bifurcation of the right common carotid artery, which was subsequently confirmed by a further neuroradiological investiga- tion. Magnetic resonance imaging of the head confirmed an acute ischemic lesion located in the right periventricular region. The carotid body tumor (CBT) was surgically removed and confirmed on histopathol- ogy. Our case reveals the role of carotid ultrasound in the diagnosis of a CBT, which may be a potential cause of stroke. Key words: carotid body tumor, stroke, ultrasound (Intern Med 55: 295-298, 2016) (DOI: 10.2169/internalmedicine.55.5350) Introduction Paragangliomas are rare tumors of the head and neck aris- ing from paraganglionic tissue which is derived from the neural crest (1). Paraganglia are chemoreceptor organs that are distributed throughout the body. They include the glomus jugulare and glomus tympanicum within the tempo- ral bone, carotid body tumors (CBTs) arising from the ca- rotid body and along the nerves in the head and neck, such as the vagal or laryngeal nerves (2). They grow slowly and rarely metastasize (3). The association between CBTs and stroke has not been clearly demonstrated in the literature, however, cerebrovascular accidents are serious postoperative complications (4). We herein describe a CBT as a potential cause of stroke and the role of carotid ultrasound. Case Report We herein present the case of a 78-year-old Caucasian woman who presented with sudden onset of left-sided hemi- paresis. Her previous medical history included arterial hy- pertension for the last twenty years and diabetes mellitus for the last two years. She was taking lisinopril, chlorthalidone and gliclazide on a regular basis. A neurological and physi- cal examination on admission showed mild to moderate left- sided hemiparesis, elevated blood pressure (190/120 mmHg) and tachycardia of 130 beats per minute. Cardiac and ca- rotid auscultation revealed no bruits. On admission to the ward, the patient’s blood pressure and heart rate had normalized. The laboratory exams were mainly within the normal ranges; we found only slight hy- perglycemia and elevated values of cholesterol (5.52 mmol/ L), low-density lipoprotein (3.76 mmol/L) and triglycerides (2.22 mmol/L). An electrocardiography (ECG) showed a si- nus rhythm with heart rate of 102 per minute. Initial com- puterized tomography (CT) of the brain showed a discrete hypodense area of the insula in the right parieto-temporal region, which was suspected to be an acute lesion with one older vascular lesion on the fronto-parietal right side. Ultra- sound of the carotid and vertebral arteries showed calcified plaques in the proximal parts of both internal carotid arteries and a highly vascularized tumor mass (dimensions of 11.8× 8.5 mm) likely to be a CBT on the bifurcation of the right common carotid artery (Fig. 1), which was confirmed with CT angiography (CTA) of the neck vessels (Fig. 2). Mag- netic resonance imaging (MRI) of the brain using the fluid- １ Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Croatia, ２ School of Medicine, Josip Juraj Stross- mayer Universty of Osijek, Croatia, ３ Department of Surgery, Sveti Duh University Hospital, Croatia, ４ Department of Radiology, Sveti Duh Uni- versity Hospital, Croatia and ５ Department of Neurology, University Hospital Center Osijek, Croatia Received for publication March 16, 2015; Accepted for publication May 7, 2015 Correspondence to Dr. Hrvoje Budin!evi", hbudincevic@gmail.com