Abstract
Background
Carotid body tumors (CBT) should be considered when evaluating every lateral neck mass.
Methods
A retrospective study was conducted of 52 patients with 57 CBT. The surgical approach and complications were reviewed. All patients were operated on without preoperative embolization.
Results
Multifocal paraganglioma (PG) were detected in six cases. A succinate dehydrogenase subunit D (SDHD) mutation was discovered in four patients. Vascular peroperative complication occurred in one case. Vascular reconstruction was decided peroperatively in five cases (8.8%). Vascular reconstruction was 0% for Shamblin 1 or 2 tumors, but 28.5% for Shamblin 3. A postoperative nerve paresis was reported in 24 patients (42.1%) and vagal nerve paralysis persisted in four cases (7.01%). The rate of serious complications, e.g., permanent nerve palsy, preoperative and postoperative complications, was 14.03%; it was 2.3% for Shamblin 1 or 2 tumors and 35.7% for Shamblin 3. One patient had malignant PG with node metastasis and was not referred for radiotherapy. No recurrence or metastasis was reported after 6-year follow-up.
Conclusion
Early surgical treatment is recommended in almost all patients after preoperative evaluation and detection of multifocal tumors. Surgical excision of small tumors was safe and without complication, but resection of Shamblin 3 tumors can be challenging. Routine preoperative embolization of carotid body paragangliomas is not required.
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References
van den Berg R. Imaging and management of head and neck paragangliomas. Eur Radiol 2005; 15:1310–8
Carroll W, Stenson K, Stringer S. Malignant carotid body tumor. Head Neck 2004; 26:301–6
Baysal BE, Ferrell RE, Willett-Brozick JE, et al. Mutations in SDHD, a mitochondrial complex II gene, in hereditary paraganglioma. Science 2000; 287:848–51
Sajid MS, Hamilton G, Baker DM, On Behalf Of Joint Vascular Research G. A multicenter review of carotid body tumour management. Eur J Vasc Endovasc Surg 2007; 34:127–30
Drovdlic CM, Myers EN, Peters JA, et al. Proportion of heritable paraganglioma cases and associated clinical characteristics. Laryngoscope 2001; 111:1822–7
Fisch JH, Klein-Weigel P, Biebl M, et al. Systematic screening and treatment evaluation of hereditary neck paragangliomas. Head Neck 2007; 29:864–73
Martin TPC, Irwing RM, Maher Er. The genetics of paragangliomas: a review. Clin Otolaryngol 2007; 32:7–11
Brink I, Schaefer O, Walz M, et al. Fluorine-18 DOPA PET imaging of paraganglioma syndrome. Clin Nucl Med 2006; 31:39–41
Gordon-Taylor G. On carotid body tumours. Br J Surg 1940; 28:163–72
Netterville JL, Reilly KM, Robertson D, et al. Carotid body tumors: a review of 30 patients with 46 tumors. Laryngoscope 1995; 105:115–26
Persky MS, Setton A, Niimi Y, et al. Combined endovascular and surgical treatment of head and neck paragangliomas–a team approach. Head Neck 2002; 24:423–31
Tewari M, Dixit A, Mongha R, et al. Control of intra-operative hemorrhage during excision of carotid body tumor. J Surg Oncol 2004; 85:55–7
Shamblin WR, Remin WH, Sheps SG, et al. Carotid body tumor (chemodectoma). clinicopathologic analysis of ninety cases. Am J Surg 1971; 122:732–9
Tikkakoski T, Luotonen J, Leinonen S, et al. Preoperative embolization in the management of neck paragangliomas. Laryngoscope 1997; 107:821–6
Lamuraglia GM, Fabian RL, Brewster DC, et al. The current surgical management of carotid body paragangliomas. J Vasc Surg 1992; 15:1038–45
Litle VR, Reilly LM, Ramos TK. Preoperative embolization of carotid body tumors: when is it appropriate? Ann Vasc Surg 1996; 10:464–8
Bakoyiannis KC, Georgopoulos SE, Klonaris CN, et al. Surgical treatment of carotid body tumors without embolization. Int Angiol 2006; 25:40–5
Robinson AC, Lukaszewicz CM. View from within–radiology in focus. Bilateral carotid body tumours. J Laryngol Otol 1989; 103:543–4
De Toma G, Nicolanti V, Plocco M, et al. Baroreflex failure syndrome after bilateral excision of carotid body tumors: an underestimated problem. J Vasc Surg 2000; 31:806–10
Manolidis S, Shohet JA, Jackson CG, et al. Malignant carotid glomus tumors. Laryngoscope 1999; 109:30–4
Dias Da Silva A, O’Donnell S, Gillespie D, et al. Malignant carotid body tumor: a case report. J Vasc Surg 2000; 32:821–3
Krych AJ, Foote RL, Brown PD, et al. Long-term results of irradiation for paraganglioma. Int J Radiat Oncol Biol Phys 2006; 65:1063–6
Elshaikh MA, Mahmoud-Ahmed AS, Kinney SE, et al. Recurrent head-and-neck chemodectomas: a comparison of surgical and radiotherapeutic results. Int J Radiat Oncol Biol Phys 2002; 52:953–6
Hinerman RW, Mendenhall WM, Amdur RJ, et al. Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body, and glomus vagale. Head Neck 2001; 23:363–71
Jansen JC, van den Berg R, Kuiper A, et al. Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 2000; 88:2811–6
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Makeieff, M., Raingeard, I., Alric, P. et al. Surgical Management of Carotid Body Tumors. Ann Surg Oncol 15, 2180–2186 (2008). https://doi.org/10.1245/s10434-008-9977-z
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DOI: https://doi.org/10.1245/s10434-008-9977-z