Carotid body tumors: a review

Abstract

Carotid body tumor or paraganglioma, is located periadventitially in relation to the carotid bifurcation. Generally, the blood supply of carotid tumors is abundant, it comes mainly from the branches of the external carotid arteries, although cases have been reported where the irrigation comes from the internal carotid artery, vertebral artery, ascending pharyngeal artery and superior thyroid. Although its etiology is unknown, different factors have been associated that contribute to its incidence, such as genetic factors and states of chronic hypoxia. Histologically, they are well vascularized tumors. Between the capillaries there are groups of tumor cells known as Zellballen's pseudoalveolar pattern. These are cells with eosinophilic granular cytoplasm and small round or oval nuclei. The tumor is mobile, but with limitation to mobilization in the cephalocaudal direction. The mass can transmit the carotid pulse due to its proximity to the carotid, and it may also be accompanied by a murmur or thrill. Usually the carotid glomus is identified by clinical examination, so consideration of multiple differential diagnoses. The treatment of choice is surgical excision. The need for preoperative embolization is controversial. Embolization before surgery is recommended to improve surgical success with reduced blood loss as well as reduce the risk of cranial nerve injury. The decision to perform presurgical embolization or not depends on the surgeon.