Advances in assessment and management of carotid body tumors

Abstract

Evolving technology has the potential to alter the overall management of carotid body tumors (CBTs). We review our 35-year experience emphasizing on novel modalities available in the evaluation and treatment of CBTs. Medical records of 27 CBT patients between 1975 and 2009 were retrospectively reviewed. The study cohort has been arbitrarily divided into two groups: the early years' group A (18 patients, 1975-1998) and the later years' group B (9 patients, 1999-2009). The most common presenting symptom was a painless lateral neck mass (89%). Octreotide scintigraphy and genetic testing were routinely used for group B. In two cases, octreotide scintigraphy was coupled with intraoperative radiolocalization of the lesion. Preoperative embolization was performed in four CBTs. Among group B patients, five were pretreated via a covered stent placement in the external carotid artery (ECA). Twenty-three patients (24 CBTs) were eventually operated upon. One cardiovascular death, one permanent vocal cord paralysis and six transient cranial nerve injuries account for a 4.4% 30-day mortality and a 30.4% morbidity with no significant differences among groups. In conclusion, appropriate use of new techniques in CBT management has improved diagnostic accuracy and early detection without clearly affecting overall outcome in our study cohort.

Neurological complications in carotid body tumors: A 6-year single-center experience

“…3 Most centers report 6-10 cases every year. [4][5][6][7] Our center is the referral center for eastern and southern India; we have noticed an increase in the numbers of patients with this rare tumor. Almost 30% of referrals may opt out of surgery; we attribute this to the relatively benign, slow-growing nature of the tumor.…”

The Effects of Preoperative Embolization on Carotid Body Paraganglioma Surgery

“…There were no randomized control trials. Only 15 studies 4,6,7,[11][12][13][14][15][16][17][18][19][20][21][22] compared surgical excision with and without preoperative embolization. Included primary studies and characteristics of relevant data available for analysis are described in Table 1.…”

Adjunct endovascular interventions in carotid body tumors

“…Unfortunately, the Shamblin classification has been adopted in only 19 of 60 (32%) of the eligible studies, 11,17,21,23,[25][26][27][28][30][31][32][33][34][35][36][37][38][39] and therefore, the benefit of preoperative embolization in CBTs of the highest size grade has yet to be demonstrated. The size of tumors treated with preoperative embolization and surgical excision was 1.6 to 11 cm, almost the same (range, 2-12 cm) in the patients treated with surgery only (Table IV).…”