Bilateral Carotid Paraganglioma: Case Report; Successful Surgical Excision, Radiological Image and Review of the Literature

Abstract

Introduction: Carotid body tumors are rare neoplasms that generally present as asymptomatic slow-growing masses in the neck, commonly called cervical paragangliomas, highly vascularized whose cells originate from the embryonic neural crest, carotid glomus tumor is uncommon, representing 1 out of every 30,000 head and neck tumors, they are located in the adventitia of the vessels, they usually grow surrounding the arteries of the carotid bifurcation and the nerves that surround it, in Ecuador the prevalence is at 55 years of age with greater frequency in women [1]. Clinical Case: A 33-year-old female patient with no significant clinical history, presented with a painful hard mass in the right cervical region that progressively increased in size, for the past 6 months. On physical examination, a tumor in the right cervical region of approximately 5 centimeters in diameter was found, with a hard consistency attached to deep planes, for which Eco Doppler and AngioTac of the neck were performed, which reported bilateral carotid paraganglioma. Excision of the glomus was necessary due to its size right carotid artery, surgery using a right cervico-lateral approach, identifying the vascular tumor mass of 4.8 x 2.9 x 2.8 cm in diameter, which was located in the carotid bifurcation. Removal of Shamblin II right carotid body paraganglioma by temporary clamping of the common carotid artery and the digital dissection method, there was no intraoperative massive bleeding or cranial nerve deficits in the postoperative period with favorable evolution, surgical wound in good condition during follow-up in outpatient consultation. Conclusion: Glomus carotid tumors are generally benign and diagnosed late. Imaging studies are essential for its diagnosis and staging.