Clinical and pathological analysis of malignant carotid body tumour: a report of nine cases

Abstract

Conclusions. Malignant carotid body tumour (MCBT) is a clinically rare disease that often invades the carotid artery and cranial nerves. Diagnosis of malignant tumour should be based on extensive invasion of neighbouring organs and distant metastasis. Extensive resection should be undertaken early. Radiotherapy is effective, whereas chemotherapy is uncertain. Objective. To summarize the clinical pathological and prognostic characteristics of MCBT and explore methods for diagnosis and treatment. Materials and methods. The study material comprised clinical, pathological, therapeutic and follow-up data concerning nine patients (four males, five females) with MCBT, treated at Tianjin Cancer Hospital between January 1956 and June 2006. The material was analysed retrospectively. Disease duration averaged 6.4 years. Shamblin classification was: one case, type II; 8 cases, type III. All nine patients underwent ultrasound examination, four underwent digital subtraction arteriography (DSA) and three had magnetic resonance angiography (MRA). Five patients underwent preoperative training of compression of the carotid (Matas test). Extensive resection was performed in all nine cases. Results. The carotid artery was blocked in three patients. In one of these the artery was reconstructed with a vascular prosthesis, while two underwent carotid ligation. Eight patients suffered from a cranial nerve dysfunction (defect) and two suffered postoperatively from a hoarse voice, four had a glossal deviation, five had Horner's syndrome and one had a deviation of the lip angle. One patient had a congestive cough. The histopathological diagnosis in all nine cases was MCBT. One patient had metastases to a cervical lymph node and lung and another had liver metastasis. The median follow-up period was 3 years (range 6 months to 14 years). Six patients survived surgery, of whom two underwent radiotherapy. Two patients died and one could not be traced.