Carotid Body Tumours: A Study of Three Cases Including a Bilateral Example

Abstract

Summary three patients who had carotid body tumours subjected to surgery are described, including a patient with bilateral tumours. in no case were any carotid vessels ligated, yet death occurred in a patient who had a unilateral tumour removed. post‐operative investigations, performed on the patient who had had bilateral tumours, involving a variation in the percentage of oxygen in the inspired air, provide suggestive evidence in favour of the hypothesis that anoxaemia with a subnormal okygen tension is the stimulus to the carotid bodies. the histology of the tumours is examined and similarities to the glomus tumour noted. their general structure indicates that they are hyperplasias; the tumour is extensively, if irregularly, innervated and many club‐shaped nerve endings can be demonstrated. the “tumour” is therefore probably a functioning tissue. diagnosis and treatment are briefly discussed, early surgery being the treatment of choice, whilst angiography may help in diagnosis. the literature of bilateral carotid bodies is briefly reviewed. the percentage of malignant carotid body tumours is considered to be negligible.

Alveolar Soft Part Sarcoma

“…With regard to the histological resemblance, this group of tumours has been studied over some years in this Department by Birrell (1952) and careful study of his material fails to convice either him or the present author that the resemblance is at all a close one.…”

“…In addition to this paucity of evidence for the relation of these tumours to the carotid body group, there are certain observations against such an origin. First, careful staining of these tumours for nerve fibres by Palmgren's method has failed to reveal any nerves in the tumour substance, although nerves in considerable numbers may be demonstrated in both the normal carotid body and its tumour (Birrell, 1952;Willis and Birrell, 1955). Secondly, the behaviour of this group of tumours is quite unlike any other tumour arising in chernoreceptors These are almost invariably benign in course although they may be locally destructive in character.…”

The Vagal Body and Its Tumour

“…The second type shows a very dark round or ovoid nucleus which is eccentric and appears almost pyknotic (Fig. It has been our experience (Birrell, 1952;Willis and Birrell) that where fibrosis is gross then nervous tissue in this type of "turnour" is either completely absent or minimal in quantity. This cell contains a relatively small amount of cytoplasm.…”

“…While perhaps too few examples have been described to allow of a definite statement as to the pathological status of this tumour, one feels that it must be regarded as comparable with the carotid body tumour, that is to say, as a hyperplasia (Chase, 1933;Birrell, 1952). Both Lattes and Stout have demonstrated a considerable number of nerves in their histological material including fine non-medullated fibrils.…”

Chemodectomas of the Carotid Bifurcation

“…Although these tumors are usually unilateral, bilateral tumors are by no means rare (HARRINGTON, CLAGETT & DOCKERTY 1941, LAHEY & WARREN 1951, BIRRELL 1952, PETTET, WOOLNER & JUDD 1953, ENGSTROM & HAMBERGER 1957, BYRNE 1958, SESSIONS, MCSWAIN, CARLSON & SCOTT 1959, WESTBURY 1960, RUSH 1962, CONLEY 1963,MoRRIS et colI. 1963, REESE, LUCAS & BERGMAN 1963, KROLL et colI.…”