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

Zhang, Wen Chao; Cheng, Jun Ping; Li, Qiang; Zhang, Lun; Wang, Xudong; Anniko, Matti

doi:10.3109/00016480802660510

Cited by 27 publications

(25 citation statements)

References 8 publications

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“…This frequency was compatible with previous reports (4)(5)(6)(7)21). It is well known that, as histopathological examination cannot distinguish a malignant tumor by morphological features in microscopic findings, malignancy or not is diagnosed by metastatic activity, namely clinical findings.…”

Section: Shamblin Classification ------------------------------------supporting

confidence: 80%

Multi-institutional survey of carotid body tumors in Japan

et al. 2018

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Abstract. There has been no attempt to clarify the status of patients with carotid body tumor (CBT) in Japan. This multi-institutional survey analyzed patients with CBT throughout Japan by gathering information on these patients from institutions that performed head and neck surgeries. Information from a total of 150 patients from 25 institutions from the past 20 years was employed in the present survey. There were 87 females and 63 males, and their mean age was 48.0 years old. The most common chief complaint was a neck mass and the mean suffering period was 46.1 months. Eighteen patients had a family history of paragangliomas and fifteen patients had bilateral CBTs. Among the 94 patients who underwent surgery to remove a CBT, 23 patients had tumors classified as Shamblin type I, 59 had type II and 12 had type III. The most frequent feeding artery of these CBTs was the ascending pharyngeal artery. Preoperative embolization of these arteries was effective in reducing blood loss; however, the operation time in Shamblin type I and II tumors was not improved. Thus these results revealed the status of patients with CBT and their treatment throughout Japan.

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Section: Shamblin Classification ------------------------------------supporting

confidence: 80%

Multi-institutional survey of carotid body tumors in Japan

et al. 2018

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“…4 In 6% to 12.5% of cases, CBTs have malignant potential and tend to grow and invade locally, causing symptoms. 5 We have reported our use of the retrocarotid dissection technique in the surgical treatment of benign CBTs, and the substantially shorter procedural times and hospital stays in comparison with using the standard caudocranial technique. 6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection.…”

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confidence: 99%

“…Intraoperatively, it is possible to see local metastasis to the lymph nodes in the neck. Zhang and colleagues, 5 who evaluated clinical and pathologic features in 9 cases of malignant CBT, found that these tumors were firm and larger than benign tumors; furthermore, the carotid artery generally could not be palpated because of tumor encasement (8 of the neoplasms were Shamblin III). 5 Malignant CBTs metastasize mainly to regional lymph nodes, and also to the lungs, bones, liver, breasts, pancreas, kidneys, and brain.…”

mentioning

confidence: 99%

“…Zhang and colleagues, 5 who evaluated clinical and pathologic features in 9 cases of malignant CBT, found that these tumors were firm and larger than benign tumors; furthermore, the carotid artery generally could not be palpated because of tumor encasement (8 of the neoplasms were Shamblin III). 5 Malignant CBTs metastasize mainly to regional lymph nodes, and also to the lungs, bones, liver, breasts, pancreas, kidneys, and brain. 10 There is no consensus as to the diagnosis of malignancy by histologic means, because some authors do not consider hypercellularity and heteromorphism to indicate malignant CBT 11 ; rather, the diagnosis is based on invasion of vessels, lymph nodes, nerves, and skull-base structures.…”

mentioning

confidence: 99%

“…Zhang and colleagues proposed that the diagnosis of malignancy is warranted when CBTs contain numerous giant cells, are polymorphic, or exhibit infiltration beyond the capsule. 5 When carotid artery resection and graft reconstruction is necessary, as in Patient 1, follow-up duplex scanning is useful to detect stenotic areas. Screening of first-degree relatives should be considered in all patients who have malignant CBT.…”

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confidence: 99%

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Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Hinojosa¹,

Anaya‐Ayala²,

Olivares-Cruz³

et al. 2018

Texas Heart Institute Journal

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A carotid body tumor (CBT) is a chemodectoma that most often originates from a gangliocytoma at the carotid bifurcation.1 These neoplasms were classified into 3 types by Shamblin and colleagues.2 A Shamblin I CBT is small and localized, a Shamblin II surrounds vessels or partially encloses them, and a Shamblin III is large and fully encloses adjacent vessels. Surgical resection, the appropriate treatment for CBT, 3 has typically been challenging because of the tumor's high vascularity, involvement of the carotid vessels, and proximity to the cranial nerves.4 In 6% to 12.5% of cases, CBTs have malignant potential and tend to grow and invade locally, causing symptoms. 5We have reported our use of the retrocarotid dissection technique in the surgical treatment of benign CBTs, and the substantially shorter procedural times and hospital stays in comparison with using the standard caudocranial technique. 6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection. Case Reports Patient 1A 17-year-old girl with no relevant medical history was referred to our institution in June 2014 with an expanding, painless, right-sided submandibular mass. She reported no pain, hoarseness, dyspnea, or dysphasia. A computed tomographic angiogram (CTA) showed a 5 × 3.7 × 6-cm hypervascular mass in the right carotid bifurcation (Fig. 1). Laboratory findings included elevated levels of plasma metanephrine (137 nmol/L; normal, <0.5 nmol/L) and normetaneprine (252 nmol/L; normal, <0.9 nmol/L). After we discussed treatment options with the patient and her parents, she underwent surgical resection.During surgery, the patient's head was turned toward her left. We then made a cervical incision centered over the carotid bifurcation, parallel and anterior to the sternocleidomastoid muscle, with extension to the mastoid region ( Fig. 2A). We extended the incision through the platysma muscle and down to the carotid sheath, and then pulled the jugular vein laterally. Proximal control of the common carotid artery was obtained just above the omohyoid muscle. Upon exposing the tendon of the digastric muscle, we identified the hypoglossal nerve and encircled it with a vessel loop. We ligated the common facial vein and performed subadventitial dissection of the mass

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Metastatic carotid body paraganglioma detected during evaluation for biliary stone disease

Oakes

Witt

Adler

2014

Diagnostic Cytopathology

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Carotid body paragangliomas are neuroendocrine cell tumors. Most invade locally to surrounding tissues with metastases being less commonly encountered than with other tumors: a minority of tumors metastasizes to distal sites. Spread is more unusual after surgical removal of the primary tumor. Hepatic spread is very rare but has been documented. We report a case of a clinically silent metastatic paraganglioma identified during an evaluation for choledocholithiasis. We describe a 70-year-old female presenting with symptoms of abdominal pain who was found to have cholelithiasis and choledocholithiasis. MRI imaging performed during evaluation revealed enhancing liver and lung lesions suspicious for metastasis. FNA of a hepatic lesion showed paraganglioma. She had a remote history of bilateral carotid body tumors, of which the left tumor was resected in 2005. This is a rare case of metastatic carotid body paraganglioma. Primary tumor source was a resected tumor or a smaller sized nodule that was managed with serial imaging. The subject's lack of symptoms and her disease extent with confirmed hepatic and presumed pulmonary spread is unique.

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

Cited by 27 publications

References 8 publications

Multi-institutional survey of carotid body tumors in Japan

Multi-institutional survey of carotid body tumors in Japan

Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Metastatic carotid body paraganglioma detected during evaluation for biliary stone disease

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