Carotid body tumour: 30 years experience

Abstract

Thirty-two patients with 37 carotid body tumours, seen in the Vascular Unit at the Royal Victoria Infirmary, Newcastle upon Tyne between 1956 and 1985 are reviewed. Twenty-six of the tumours were treated by surgical excision. There were no peri- or postoperative deaths, but one patient developed a permanent hemiplegia following surgery (3.8 per cent); cranial nerve palsy occurred in five patients (19.2 per cent). There were no malignant tumours although in one patient, histology of the resected specimen showed the presence of local lymph node invasion (3.8 per cent). In the 7 patients who did not undergo surgery, 3 have been lost to follow-up; the remainder have not shown any significant increase in the size of the tumour. One patient was treated by radiotherapy. It is concluded that surgical excision is the treatment of choice, though observation may be preferred for the older patient with a symptomless, slow-growing tumour. To help reduce the risk of hemiplegia (the most serious complication of surgery) a meticulous surgical technique is necessary and heparin, intraluminal shunting and facilities for arterial repair and grafting must be at hand.

Carotid body tumors in inhabitants of altitudes higher than 2000 meters above sea level

“…Carrau 2 reports a ratio of 1:1 in 23 cases in the U.S. Parry,17 in 222 cases of CBT collected from different studies, reported a female predominance of 2:1, and a similar ratio was found by Dickinson in England. 18 Nevertheless, in inhabitants in the Peruvian Andes at more than 2000 m of altitude, the female predominance was 6.33:1, 19 and there is a study of patients in the Valley of Mexico where the female predominance reached a ratio of 19:1. 20 We conclude that women inhabitants of altitudes more than 2000 m above sea level have a greater risk of developing CBT than do men and that this predominance diminishes in direct relationship to the altitude (Table 1).…”

Late outcome after surgical management of carotid body tumors from a 20-year single-center experience

“…That's because cranial nerves are often adherent or incorporated in the surface of large tumors. The majority of cranial nerve deficits are temporary though and the incidence of permanent cranial nerve palsy is low in international literature [1,4,[25][26][27][28][29][30][31][32]. Of our seven patients with postoperative cranial nerve dysfunction, five were neurologically completely asymptomatic at last follow-up.…”

“…The high rate of cranial nerve deficit on first postoperative day in our series (41.2%) is comparable with the published data from other centers. Reports raise the incidence of cranial nerve deficit after CBT surgery up to 49% (Table 2) [1,4,[25][26][27][28][29][30][31][32]. Large Shamblin type III tumors carry the highest risk of postoperative cranial nerve dysfunction (Table 1).…”

Surgical treatment of paragangliomas of the carotid bifurcation: Results of 36 patients

“…Although we had not seen complications with those procedures, these are described in the literature. 7,8 Furthermore, prior biopsies were not able to determine the diagnosis. The noninvasive diagnostic tools available now allow for a precise diagnosis in most patients without the need for preoperative pathologic examination.…”