Case Of Carotid Body Tumor Research Articles

Central Nonenhancement Sign in Carotid Body Tumor on CT Angiography

AbstractCarotid body tumors are rare benign tumors that arise in the carotid space of neck typically presenting as soft to firm, painless swelling in the neck. While specific imaging characteristics have been previously described for carotid body tumors, we report a new imaging sign in three cases of carotid body tumors on computed tomography angiography.

Malignant carotid body tumor: a report of two cases.

Case one- A 23-year-old woman presented with a right-sided neck mass. History, physical examination, and appropriate imaging suggested malignant paraganglioma with evidence of lymph node, vertebral, and lung metastases. Surgical excision of the tumor and regional lymph nodes was done. Histopathological assessment of the retrieved specimens confirmed the diagnosis. Case two - A 29-year-old woman presented with a left submandibular swelling. She was appropriately investigated, and the diagnosis of a malignant carotid body tumor was made with evidence of lymph node metastasis. Surgical resection of the tumor with clear margins was done and histopathological analysis of the resected specimen confirmed the diagnosis. CBT's are the most common tumors of the head and neck. Most are nonfunctioning, slow growing, and benign. They typically present in the fifth decade of life but can occur at a younger age in individuals who carry certain genetic mutations. Both cases of malignant CBT's that we encountered occurred in young women. Furthermore, the 4-year and 7-year history in case number one and two, respectively, supports the fact that CBTs are slow growing tumors. In our case series, the tumors were surgically resected. Both cases were discussed in multidisciplinary meetings and were referred for hereditary testing and radiation oncology for further management. Malignant carotid body tumors are rare. Prompt diagnosis and treatment is important to improve patient outcomes.

Association of Complications During and After Carotid Body Tumor Resection with Tumor Size and Distance to the Base of Skull

Depending on the size and location of the tumor, carotid body tumor (CBT) resection can come with various complications, mostly intraoperative bleeding, and cranial nerve injuries. In the present study, we aim to evaluate two fairly new variables, tumor volume, and distance to the base of the skull (DTBOS), with operative complications of carotid body tumor (CBT) resection. Patients who underwent carotid body tumor surgery in Namazi hospital from 2015 to 2019 were studied using standard databases. Tumor characteristics and distance to the base of the skull were measured via computed tomography or Magnetic resonance imaging. Outcomes, including intraoperative bleeding and cranial nerve injuries, along with perioperative data were collected. A total of 42 cases of CBT were evaluated with an average age of 53.21±12.8 and mostly female (85.7%). Based on Shamblin scoring, 2 (4.8%) were classified as group I, 25 (59.5%) as group II, and 15 (35.7%) as group III. The amount of bleeding significantly increased with an increase in the Shamblin scores (P=0.031; median: I: 45cc; II: 250cc, III: 400cc). Also, there was a significant positive correlation between the size of the tumor and the estimated amount of bleeding (Correlation Coefficient = 0.660; P<0.001), and also a significant reverse correlation with between bleeding and DTBOS (Correlation Coefficient= -0.345; P=0.025). During the follow-up of the patients, six (14.3%) had abnormalities in their neurological evaluation. Receiver operating characteristic curve analysis revealed the size of tumor cutoff level 32.7 cm3 (3.2cm radius) to be most predictive of post-op neurological complication with an area under the curve=0.83, sensitivity=83.3%, specificity=80.6%, a negative predictive value= 96.7%, and positive predictive value of 41.7%, and an accuracy of 81.0%. Furthermore, based on the predictive power of the models in our study, we demonstrated that a combination model including the tumor size, DTBOS, along with the Shamblin score had the most predictive power for neurological complications. By evaluating CBT size and distance to the base of the skull, paired with the use of the Shamblin classification, a better, more insightful understanding of possible risks and complications of CBT resection can be obtained, leading to deserved levels of patient care.

Carotid Body Tumors: Institutional Experience of 10 Cases and a Review of Literature.

Carotid body tumors are slow growing neck masses that arise from the neural crest cells at the carotid bifurcation. Majority are asymptomatic and are diagnosed incidentally. Surgical excision is accepted as the treatment of choice to reduce complications. In the present series, we report 10 cases of carotid body tumors and our institutional experience. All patients underwent radiological evaluation with an ultrasonography with Doppler, contrast enhanced computed tomography and MR angiography. 6 cases were operated by a transcervical excision. The tumor was excised in tototranscervically. One of the cases required saphenous vein graft intraoperatively due to vascular injury and also had postoperative vocal cord palsy. The rest had an uneventful recovery. Carotid body tumors although rare and seemingly indolent can cause substantial symptoms if left untreated. A prompt multi modality approach is needed for both diagnosis and treatment to avoid major complications.

Sex differences according to ethnic presentation in carotid body tumors: a systematic literature review

&lt;p&gt;Compare through a systematic literature review, the sex distribution of patients with carotid body tumors in Mexico and Latin America with the rest of the world. The eligibility criteria included retrospective cohort studies of more than 15 patients with a diagnosis of carotid body tumor (regardless of Shamblin's classification or clinical manifestations), which also reported the number of women and men affected, as well as their mean age. We divided the countries where the studies were conducted into regions (Latin America, USA, and Europe/Asia). The sex ratio difference between regions was calculated using a chi-square test. A p&amp;lt;0.05 was considered statistically significant. Thirty-eight studies met the eligibility criteria. Latin America had 1,345 cases, the United States had 808, and Europe/Asia had 672. Mexico had the most cases (1125), followed by the United States. The rest of the countries had less than 30 cases each. We found a statistically significant differences when we compared Latin American countries with the United States and Europe/ Asia (p&amp;lt;0.001). However, the most significant difference was observed when we compared Mexico with the United States, Europe/Asia, and other Latin American countries. When comparing other Latin American countries with Europe/Asia, we found a statistical difference (p=0.01); however, there was no statistical difference (p=0.05) when we compared other Latin American countries with the United States. Mexico has the highest number of reported cases of carotid body tumors in the world. Women account for 90% of cases.&lt;/p&gt;

Recurrent Gigantic Bilateral Carotid Body Tumors (Paraganglioma): A Rare Case Report

Carotid body tumors (CBTs) affect the chemoreceptors located in the carotid artery bifurcation, and ∼30% will present bilaterally. We report a rare case of bilateral CBTs. The left-side CBT was recurrent after a failed complete excision attempt. Staged surgical excision of both CBTs was planned. Such cases present a real surgical challenge for the surgeon and surgical team. They require meticulous preoperative evaluation, careful operative dissection, prompt decisions, and a multidisciplinary approach for successful outcomes.

A rare case of carotid body tumor associated with near complete cerebral sinus thrombosis and idiopathic intracranial hypertension. Management strategy and review of the literature

Background: Carotid body tumors (CBTs) are rare hypervascular lesions with critical location which makes them very challenging to treat. In rare occasions, compression of the jugular vein from the tumor mass could predispose to progressive thrombosis of intracranial venous sinuses. The latter consequently leads to intracranial hypertension (pseudotumor cerebri) with the accompanying danger to the vision. Herewith, we present our management strategy for this rare presentation of CBTs.Case Description: A 38-year-old woman, with no medical history, was admitted in the emergency unit with acute onset of headache, dizziness, and vomiting. On the diagnostic imaging studies (CT venography and MRI) a near total occlusion of all cerebral venous sinuses and a large CBT (Shambin Type II) were diagnosed. Initially, the patient was treated with anticoagulants for the thrombosis and with lumbo-peritoneal (LP) shunt for the management of pseudotumor cerebri. At a second stage, after resolution of the cerebral sinus thrombosis, the CBT was completely resected under electrophysiological monitoring, without preoperative embolization. At 1-year follow-up, the patient is neurologically intact with functioning LP shunt, patent cerebral venous sinuses, without tumor recurrence.Conclusion: We present a rare case of CBT with intracranial complications, which was managed successfully by staged treatment. Careful study of the preoperative radiological and laboratory data, thorough preoperative planning of the tridimensional lesion anatomy, as well as meticulous microsurgical technique under intraoperative electrophysiological monitoring was essential for the successful outcome of the case.

Diagnostic Dilemma in a Carotid Body Tumor: A Case Report

An asymptomatic swelling in the neck region has many differential diagnoses. Most common of them is reactive lymphadenitis and carotid body tumor being the last thing. We present here a case of carotid body tumor that misguided us on clinical and radiological ground. It was suspected intra-operatively and confirmed by histopathological examination. Carotid body tumors are rare neoplasm. It arises from the chemoreceptor cells of the carotid bulb. We report a case of carotid body tumor in a 57-year-old female, who presented with painless, gradually progressive lateral neck swelling. The diagnosis is suspected on the basis of clinical radiological and per-operative examination findings. Histopathological examination confirms the diagnosis of carotid body tumor

Carotid Body Tumor: A Case Report and Review of Literature.

Carotid body tumour (CBT) is a rare hypervascular tumor in the head and neck region. It develops from neural crest origin paraganglionic tissue which is an arterial chemoreceptor. It presents as a slow growing mass at the carotid bifurcation. Its optimal evaluation and treatment requires involvement of multiple specialities. Because of the high rate of neurovascular complications, resection of this tumor is challenging for surgeons. Early tumor detection, meticulous evaluation and multidisciplinary approach are vital for successful management of these tumors. A case of CBT in a 50year-old lady managed at our centre is being reported here along with a review of literature.

A rare case of Scwannoma at carotid space of neck region mimicking as Paraganglioma.

This is a case of carotid body tumour at right side of neck region with initially diagnosed as paraganglioma. A 22 year old female patient with an history of pain and swelling at right side of neck region with intermittent headache difficulty during deglutination. Patient has taken medication for pulmonary kochs for 8 months. Now presented with the mentioned complaints with a swelling at right side swelling at neck region. The features and the correlation with MRI report diagnosed as paraganglioma and then on Histopathologic examination showed a tumour mass composed of two different areas admixed with each other either alternatively or diffusely. The final pathological impression was Neurilemmoma (Schwannoma).The diagnosis was definitive with no evidence of paraganglioma.

Case of a Malignant Carotid Body Tumor With Systemic Metastases: The Utility of Multimodal Imaging

Carotid body tumors (CBTs) are rare neoplastic paragangliomas that are typically benign; however, 10% to 15% are malignant with local invasion and, in rare cases, metastases systemically. A 45-year-old woman with a familial history of CBT presented following a syncopal episode. Multimodal imaging confirmed the presence of bilateral CBTs. 68Gallium-DOTATATE Positron Emission Tomography (DOTATATE-PET) scans revealed distant systemic metastases in the liver and vertebra. Surgical intervention was undertaken to excise the less complex right CBT. This report presents a case of malignant CBT with systemic metastases, describing the postintervention multimodal imaging findings with a focus on the duplex ultrasound features.

Carotid body tumour: an enigma that remains

&lt;p class="abstract"&gt;Carotid body tumour is a form of paraganglioma which arises from the carotid body. This tumour is known for its rich vascular supply mainly contributed by the ascending pharyngeal artery, a branch from external carotid artery. Surgical excision preceded by pre-operatic embolization remains the definitive treatment despite the countless feared complications. We present our experience with a case of carotid body tumour which was embolised prior to surgical excision, unfortunately complicated with a thromboembolic event. This patient was found to have an anatomical variation in the cerebrovascular anatomy known as a fetal posterior cerebral artery which led to a paradoxical PCA infarction post-embolization. We would like to highlight this rare presentation along with its management as there were scarce evidence of this case in the literature.&lt;/p&gt;

An aneurysm-like entity inside a giant carotid body tumor reaching lateral skull base

The successful resection of giant carotid body tumors (CBTs) with full protection of cranial nerve is challenging. Meanwhile, entities with fresh blood inside a CBT were commonly considered liquefactive necrosis preoperatively. However, we reported a case with an aneurysm-like entity inside the CBT instead. A patient with lump on the right neck complained of feeling dizzy. She was then reported with a giant CBT reaching lateral skull base. Preoperative imaging revealed a low-density entity inside the tumor, which was considered as liquefaction necrosis. However, during surgery, the low-density area was observed pulsing with fresh blood. Under the collaboration of vascular surgeons and otolaryngologists, the tumor was resected uneventfully. We reported a case of giant CBT over 10 cm and successful resection with no major facial nerve deficit. Moreover, an aneurysm-like entity inside the tumor was observed during the surgery, which was not reported before.

SDHx gene detection and clinical Phenotypic analysis of multiple paraganglioma in the head and neck

The goal of this study was to detect and explore the mechanisms of the succinate dehydrogenase (SDH) complex subunit-related gene mutations in cases of multiple paraganglioma (PGL) in the head and neck. In Beijing Tongren Hospital (Capital Medical University, Beijing, People's Republic of China) between January 2013 and February 2017, 23 cases of head and neck multiple PGL were evaluated by genetic sequencing. From these cases, four hereditary families and 10 cases with sporadic occurrences were found. Gene mutations, including SDHD, SDHB, SDHC, SDHAF2, VHL and RET in germ cells and somatic cells, were detected by gene capture and high throughput sequencing. In family 1, 12 instances of SDHD gene mutation were detected, eight of which manifested as bilateral carotid body tumor (CBT) with one bilateral malignant CBT. In family 2, three cases of SDHD mutation were found with one case of bilateral CBT and two cases of unilateral CBT. In family 3, two cases of SDHD gene mutation were found, both characterized by vagus PGL and pheochromocytoma. Of the 10 patients with sporadic manifestations, five cases of SDHD gene mutation and one case of RET gene mutation were detected. Two novel gene mutations, c.387_393del7 mutation of SDHD gene and c.3247A>G mutation of RET gene, were also detected. In patients with multiple PGL in the head and neck, these are accompanied by a genetic mutation of the germ cell. In this case study, this mutation was most commonly a mutation of the SDHD gene. 4 Laryngoscope, 129:E67-E71, 2019.

Actual methods of carotid body tumor diagnosis

The aim — to improve the carotid body tumors (CBT) diagnosis.Materials and methods. The article presents with the analysis of the structure and the results of the diagnosis and surgical treatment of 65 patients who were hospitalized in the department of vascular surgery Lviv Regional Clinical Hospital for the period 1995 to 2016. There were 36 cases of carotid body tumor and 29 cases other tumors of the neck, which were directed from other medical institutions with a diagnosis of «carotid body tumor». The examination of patients included physical examination, ultrasonography, computer tomography, MRI. Final diagnosis verification was confirmed with pathological and histological clinical report.Results and discussion. At the initial examination of patients the symptom «plus» tissue was identified palpatory on the neck: left or right side in the projection of the bifurcation of the common carotid artery in 36 patients. In 5 (14 % of the CBT) patients synchronous lesions were found on both sides of the neck in the projection of the bifurcation of the common carotid artery. On palpation the carotid body tumor was of stiffly — elastic consistency, painless, not soldered to surrounding tissues and slightly shifted transverse axis of the neck, pulsing in sync with carotid artery. All patients underwent carotid ultrasonographic examination with the calculated diagnostic sensitivity of ultrasound to detect tumors, that was 93 %, specificity — 92 %, accuracy — 92 %/In the study patients’ ultrasonography was complemented with contrast computer tomography in 14 (22 %) cases and MRI in 2 (3 %). Biopsy of the tumor and sentinel node was performed in 2 (3 %) patients with CBT and 5 (8 %) patients with tumors of different origin. However, biopsy was not informative because received histological material was without specific changes and prevented from identification of tumor genesis pre surgery stage.Conclusions. Ultrasound is a highly informative and specific method for diagnosis of carotid body tumor. USG can be used for differential diagnosis of the neck carotid body tumor from other tumors on pre surgey stage.

Experience for surgical treatment and analyzing complication of carotid body tumor

Objective To analyze and summarize the experience of surgical treatment of carotid body tumor and prevention of relevant complications. Methods The clinical data of 45 cases of carotid body tumor diagnosed and treated by Department of Vascular Surgery, People′s Hospital of Xinjiang Uygur Autonomous Region from August 1996 to June 2016 were retrospectively analyzed. All the patients were followed up for 18 months and were followed up in Department of Vascular Surgery, People′s Hospital of Xinjiang Uygur Autonomous Region inpatient or outpatient review form, the main observation during follow-up of patients with postoperative complications and recovery.Carotid compression test (Matas test) will be performed 2 weeks preoperation. There were 20 males (4 carotid body lesions located on both sides, 16 carotid body lesions on the unilateral side) and 25 females (1 carotid body lesion located on both sides of the neck, neck arteriomatous lesions in unilateral patients were 24 cases), duration of 0.5 to 6.0 years, the average duration of 3 years, analysis of postoperative complications. Results All the operations were successful. There were no perioperative deaths. Among the 45 patients undergoing surgical treatment, one or more surgical procedures were used. Thirty patients were followed up and the remaining 15 patients were lost to follow-up. During an average follow-up of 18 months, complications included 1 stroke, 8 hypoglossal nerve injury, 13 vagal injury and 9 horner syndrome. No recurrence of patients was followed up within 6 months, the basic symptoms of nerve injury, 1 case of vagus nerve and the tumor was followed up for 6 months, there was still difficulty swallowing and hoarseness. Five cases of bilateral lesions, including 3 cases underwent bilateral staging surgery, the operation was successful. One case of unilateral excision after vagal injury, it did not contralateral surgery; one case of one-sided surgery after the lost, the contralateral did not receive surgery. Conclusions Hoarseness after operation is not caused by recurrent laryngeal nerve injury, and it was recommended that bilateran lesions with smaller one should removed firstly. Matas test could not be regarded as criterion of intra-operative ligation during the operation. Key words: Carotid body tumor; Surgical procedures, operative; Postoperative complications

超音波凝固切開装置および血管マイクロクリップを用いて切除した頸動脈小体腫瘍の 1 例

超音波凝固切開装置および血管マイクロクリップを用いて切除した頸動脈小体腫瘍の 1 例

CAROTID BODY TUMOR MASQUERADING AS AN ISOLATED SUBMANDIBULAR LYMPH NODE- A CASE REPORT AND LITERATURE REVIEW

Carotid body tumors (CBT) are very rare tumors and CBT masquerading as a submandibular lymph node are even rarer. The authors report a case of a middle aged male who was referred to the Otolaryngology department for investigation of a suspected/ apparent left submandibular lymph node. It was slow growing in nature, painless and firm to the touch but was otherwise asymptomatic. Given this presentation and his history of smoking two (2) packs of cigarettes a day for fifty-three (53) years a malignancy of the head and neck area was suspected. A Fine Needle Aspiration Cytology (FNAC) was done at his first visit and this was negative for malignancy. A Computed Tomography (CT) scan of the neck revealed a mass within the carotid sheath with the characteristic Lyre sign: the splaying of the internal and external carotid arteries typical of a paraganglioma or chemodectoma. Based on the recommendations of Shamblin, this case was classified as a Shamblin I, i.e. a perfect candidate for surgical resection. After adequate preparation, informed consent and further imaging, the tumor was resected an uneventful recovery was to be in keeping with the dictum of the Shamblin classification. The histology was reported as a Paraganglioma with no atypical features. We think this is the first reported case of CBT from the Caribbean countries.

A Case of Large Carotid Body Tumor: Surgical Challenge

Carotid body tumors (CBTs) are rare benign tumors, but they do have a chance of turning into malignant tumors. Hence, the earliest mode of treatment is surgical resection. The high vascularity of the tumors poses a surgical and anesthetic challenge. Hereby, we present a successfully resected case of large CBT measuring 7 cm × 6 cm. In contrast-computed tomography angiogram of the neck, the hyperdense mass was noted in the left carotid space splaying the left internal carotid artery and external carotid artery. Conventional general anesthesia with controlled ventilation technique was used in the resection of this tumor. The final histopathology report was paraganglioma. She had an uneventful perioperative period and was doing well after 18 months of follow-up.

Fine-needle aspiration cytology diagnosis of paraganglioma (carotid body tumor)

A case of carotid body tumor was diagnosed based on fine-needle aspiration cytology (FNAC) in 22-year-old female who presented with a mass in the right lower cervical region. Provisional diagnosis was made as metastatic deposits. However, this case was diagnosed on FNAC as carotid body tumor due to the presence of definite diagnostic features on cytology like hemorrhagic aspirate, with clusters and as well as discrete cells, which are round to oval with moderate anisokaryosis, indistinct cell outlines, stippled chromatin and fine granular cytoplasm. Focal attempted acinar formation was also seen. Based on these cytologic findings and the location of the swelling, a diagnosis of carotid body tumor was made. The diagnosis was confirmed on histopathological examination. Carotid body tumor is arising from the chief cells of the carotid body, which is situated at the bifurcation of the common carotid artery. Though the fine needle aspiration was seldom suggested for the diagnosis of carotid body tumor due to its location, there were no complications during the procedure in this case. As the role of FNAC in the diagnosis of carotid body, tumor is minimized due to the severe bleeding complications of the procedure and only few cases were reported in the literature until now. However in this case, the main diagnosis was made by FNAC without any complications.