Carotid body tumors: Surgical experience in 215 cases

Pacheco-Ojeda, Luis

doi:10.1016/j.jcms.2017.06.007

Cited by 37 publications

(33 citation statements)

References 26 publications

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“… 2 , 9 The hyperplastic etiology is thought to be related to chronic hypoxia due to factors such as chronic lung disease and high altitude. 12 , 14 …”

Section: Introductionmentioning

confidence: 99%

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

et al. 2021

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Objective: Compare the effects of preoperative embolization for carotid body tumor resection on surgical outcomes to carotid body tumor resections without preoperative embolization. Methods: Single-center retrospective review of all consecutive patients who underwent carotid body tumor resection from 2001 to 2019. Surgical outcomes with emphasis on operative time (estimated blood loss and cranial nerve injury) of patients undergoing carotid body tumor resection following preoperative embolization were compared to those undergoing resection alone using unpaired Student’s t-test and Fisher’s exact test. Results: Forty-six patients (15% male, mean age 50 ± 15 years) underwent resection of 49 carotid body tumors. Patients undergoing preoperative embolization ( n = 20 (40%)) had larger mean tumor size (4.0 ± 0.7 vs 3.2 ± 1 cm, p = 0.006), increased Shamblin II/III tumor classification (18 (90%) vs 22 (76%), p < 0.001), operative time (337 ± 195 vs 199 ± 100 min, p = 0.004), and cranial nerve injuries overall (8 (40%) vs 2 (10%), p = 0.01) compared to patients undergoing resection without preoperative embolization ( n = 29 (60%)). In subgroup analysis of Shamblin II/III classification tumors ( n = 40), preoperative embolization ( n = 18) was associated with increased tumor size (4.1 ± 0.6 vs 3.5 ± 0.9 cm, p = 0.01), operative time (351 ± 191 vs 244 ± 105 min, p = 0.02), and cranial nerve injury overall (8 (44%) vs 2 (9%), p = 0.03) compared to resections alone ( n = 19). In further subgroup analysis of large (⩾ 3 cm) tumors ( n = 37), preoperative embolization ( n = 18) was associated with increased operative time (350 ± 191 vs 198 ± 99 min, p = 0.006) and cranial nerve injury overall (8 (44%) vs 2 (11%), p = 0.03) compared to resections alone ( n = 19). There were no significant differences in estimated blood loss, transfusion requirement, or hematoma formation between any of the embolization and non-embolization subgroups. Conclusion: After controlling for tumor Shamblin classification and size, carotid body tumor resections following preoperative embolization were associated with increased operative time and inferior surgical outcomes compared to those tumors undergoing resection alone. Nonetheless, such results remain susceptible to the confounding effects of individual tumor characteristics often used in the decision to perform preoperative embolization, underscoring the need for prospective studies evaluating the utility of preoperative embolization for carotid body tumors.

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“… 2 , 9 The hyperplastic etiology is thought to be related to chronic hypoxia due to factors such as chronic lung disease and high altitude. 12 , 14 …”

Section: Introductionmentioning

confidence: 99%

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

et al. 2021

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“…In the absence of specific histopathological criteria, malignancy is marked by the anatomical presence of metastases [10], with a predilection for regional lymph nodes, and very rare distant metastases [3]. The therapeutic method of choice for carotid body tumors is surgical removal, which in select cases may be preceded by angiographic embolization [8,25]. Embolization may reduce the size of the tumor and promote its disconnection from the vascular system, thereby reducing intraoperative bleeding [13,36].…”

Section: Discussionmentioning

confidence: 99%

“…Embolization may reduce the size of the tumor and promote its disconnection from the vascular system, thereby reducing intraoperative bleeding [13,36]. Among the significant complications of surgical treatment are secondary bleeding, cranial nerve deficiency, and perioperative stroke; therefore, the intervention requires caution in aged patients, especially in patients with cardio-ischemic pathology despite the general addressability of the surgery [7,8,13,25,36].…”

Section: Discussionmentioning

confidence: 99%

Carotid paragangliomas: case report and imaging review

Baz¹,

Scheau

Sârbu

et al. 2021

Folia Morphol

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Background: Presentation of case reviews depicting the imaging characteristics of carotid paragangliomas, associated with a thorough analysis of the anatomical morphological features and the current therapeutic strategies. Methods: We present the cases of three patients diagnosed with carotid paragangliomas in our clinic, illustrating diagnostic imaging elements by computer tomography (CT) and magnetic resonance imaging (MRI), but also the postoperative aspect of the carotid system, with respective anatomical, clinical and surgical considerations. Results: The imaging aspect of the carotid paragangliomas is characterized by a mass of soft tissue with intense contrast enhancement and with "salt and pepper" MRI appearance on conventional spin-echo sequences. The postoperative evolution of the patients included in the article was favorable, without any perioperative complications or signs of local tumor recurrence. Conclusions: Carotid paragangliomas are rare, often asymptomatic tumors, but with potential for increased malignancy, which raises the need for good knowledge of the cervical region pathology as well as the features of neuroendocrine tumors. CT and MRI examinations are essential for diagnosis, staging and, implicitly, for establishing the therapeutic strategy.

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“…CBT are the most common head and neck paragangliomas [1,5]. Although some studies have suggested that CBTs are more common in males [7,8], it appears that women are more often affected [2,4,5,6,9,10,11], constituting up to 95% of patients [10]. Unsurprisingly, a large systematic review of 19 studies con- firmed that female patients are more likely to be affected [12].…”

Section: Discussionmentioning

confidence: 99%

Carotid body paragangliomas – clinical variety and management (RCD code: I-O)

Chmiel

Loska

Brzychczy

et al. 2019

Journal of Rare Cardiovascular Diseases

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Paragangliomas (PGLs) are a group of rare, slow-growing tumours which are found between the base of the skull and the pelvis. The tumour is often asymptomatic, although a lump on the neck, cranial nerve palsy, or neck pain may be present. The treatment of choice is surgical resection. We present the cases of 7 patients (6 females) diagnosed with 9 PGLs of the carotid body (carotid body tumours -CBTs). These include: one case with known genetic burden, one of an advanced bilateral and recurrent tumour, and one with a malignant tumour. All presented CBTs were surgically removed. The size of a tumour correlates with postoperative complications. Resection of the largest lesion was associated with persistent left recurrent laryngeal, hypoglossal, and partial facial nerve paralysis. Other complications included single cranial nerve palsy and temporary Horner syndrome.

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Carotid body tumors: Surgical experience in 215 cases

Cited by 37 publications

References 26 publications

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

Carotid paragangliomas: case report and imaging review

Carotid body paragangliomas – clinical variety and management (RCD code: I-O)

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