Dolichoarteriopathia of Bilateral Common Carotid Artery Presenting as Mass in Pyriform Fossae Causing Dysphagia: An Anatomical Anomaly.

A rare case of aberrant tortuous common carotid artery (dolichoarteriopathia) presenting as submucosal swellings in bilateral pyriform sinuses, non-pulsatile, mimicking submucosal growths in an elderly female with complaints of dysphagia for solids, is described. CT with contrast by the radiologist opined the swellings as common carotid dolichoarteriopathia. We discussed the presentation of the anomaly in head and neck briefly by reviewing the literature and the hazards of biopsy in such a situation. Flexible fibreoptic videoendoscopy, CT with contrast of the head and neck, and the radiologist's opinion gave the clue to diagnosis. The non-pulsatile masses in the pyriform sinuses, is intriguing and minimally invasive procedure like biopsy would have been fatal. One should be careful in dealing with such non-pulsatile submucosal swellings in the laryngopharynx without proper investigations. Anomalies of common carotid artery (CCA) are rare in clinical experience. Choi et al. (Eur Arch Otorhinolaryngol 255(5):269-270, 1998) reported tortuous CCA in neck dissection for cancer but in clinical practice, the abnormal course of CCA presenting in pyriform sinus is extremely rare.