Carotid Body Tumours: Benign but Challenging

Kakisis, John D.; Geroulakos, George

doi:10.1016/j.ejvs.2018.12.005

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…A CTA or MRA and the high-resolution images they offer assist the surgeon in formulating the surgical strategy because of the excellent illustration of the vascular anatomy they provide [ 4 , 7 ]. Although MRI does not use ionizing radiation and often offers higher accuracy [ 6 ], the ability of CTA to measure tumor size and its association with bony structures seems to be a major advantage in surgical planning and perioperative complication risk prediction [ 10 , 11 , 14 , 15 ]. Aspiration needle biopsy has been reported in the literature for the diagnosis of carotid body tumors; however, we do not perform the procedure in our clinic because of the significantly increased risk of related complications, including massive hemorrhage, pseudoaneurysm formation, and carotid thrombosis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Carotid Body Tumor in a 26-Year-Old Male Patient Managed With Preoperative Embolization

Avgerinos,

Troupis

et al. 2023

Cureus

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Carotid body tumors are rare, highly vascularized neuroendocrine tumors that arise near the bifurcation of the common carotid artery (CCA). Controversy exists in the management of those tumors about whether preoperative embolization facilitates surgical excision and decreases perioperative complication risk. We present the case of a 26-year-old patient with a carotid body tumor manifesting as a painless pulsatile mass in the anterior triangle over the left side of the neck and provide details of the preoperative diagnostic steps. Treatment included preoperative embolization of the tumor followed by surgical excision after 48 hours to safely address this rare pathology, resulting in a favorable outcome for the patient.

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Section: Discussionmentioning

confidence: 99%

Carotid Body Tumor in a 26-Year-Old Male Patient Managed With Preoperative Embolization

Avgerinos,

Troupis

et al. 2023

Cureus

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“…CN deficits have been reported to occur in 11–49% of patients after CBT resection ( 22 – 26 ). The Shamblin classification is predictive of the risk of CNI ( 27 ). Consistent with previous studies, patients with higher Shamblin grade tumors presented with a higher incidence of CNI in our study ( 5 , 18 – 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…While the prediction of complications is important for decision making, preoperative planning, and for obtaining the informed consent, prevention of complications is even more important. Meticulous surgical techniques and timely operations in the initial stages of FCBTs are the optimal way to minimize complications ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Surgical Outcomes of Carotid Body Tumors With Pathological Fibrosis: A Cohort Study

et al. 2021

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ObjectiveTo compare the surgical outcomes of carotid body tumor (CBT) with or without pathological fibrosis, and evaluate the associated factors of fibrous CBT (FCBT).Materials and MethodsParaffin-embedded tissues of 236 patients with unilateral CBTs at our center were retrospectively reviewed from January 2008 to May 2020. Based on the pathologic features, CBTs were divided into FCBT and conventional CBT (CCBT) groups. The clinical data and surgical outcomes of the two groups were compared.ResultsOf 236 patients, 53 had FCBT and 183 had CCBT. FCBTs showed higher vascular invasion (24.53%), marked pleomorphism (22.64%), internal carotid artery reconstruction (37.74%), estimated blood loss (559.62 cm3), and postoperative nerve injury (49.06%), with lower 10-year recurrence- (89.2%) and major adverse event-free survival (87.3%) compared to CCBTs. Nerve injury was correlated with the Shamblin grade; major adverse events and nerve injury were both correlated with pathological fibrosis.ConclusionCompared with CCBT, FCBT is prone to increased recurrence, metastasis, major adverse events, and nerve injury risk. Early surgical resection, routine excision of surrounding abnormal lymph nodes, and closer clinical surveillance in FCBT patients are recommended.

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“…Preoperative embolization prior to surgical excision of CBTs has been reported to reduce blood loss and thus provide better operational visualization, facilitate tumor excision and decrease morbidity related to perioperative complications ( 5 , 6 ). However, the embolization of the feeding arteries of CBTs can also cause some unwanted complications, such as ectopic embolization or stroke ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Surgical resection of CBTs is currently the gold standard for the treatment of disease, but the operation can frequently be tricky because of the adjacent neurovascular structures that may be involved in the tumors, especially in the case of advanced Shamblin classification ( 1 , 2 ). Excessive blood loss and cranial nerve damage may be the most worrying complications during the operation; excessive intraoperative bleeding may increase the chances of cranial nerve injury and thus complicate the operation ( 3 , 4 ). Preoperative embolization prior to surgical excision of CBTs has been reported to reduce blood loss and thus provide better operational visualization, facilitate tumor excision and decrease morbidity related to perioperative complications ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

The Comparative Outcomes of Particulate Versus Coil Preoperative Embolization for Carotid Body Tumors

et al. 2022

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Till now, the effect of different embolic materials (particulate vs coil) on pre-embolization of carotid body tumors remains poorly understood. The aim of this study was to explore the comparative results between particulate and coil embolization for carotid body tumors. Thirty-seven patients with carotid body tumors who underwent embolization before surgical resection were reviewed and analyzed in this retrospective study between 2008 and 2020. Twenty-one patients were included in the particulate group, while 16 patients were included in the coil group. All procedure-related details, complications and 5-year follow-up data were collected in the study. The preoperative embolization time was obviously longer in the particulate group than in the coil group (42.6 ± 12.3 min vs. 33.7 ± 10.1 min, P =.02), and the fluo time of the procedure (864.5 ± 240.9 s vs. 729.6 ± 251.5 s) and cumulative air kerma (634.6 ± 188.4 mGy vs. 486.7 ± 164.7 mGy) value were higher in the particulate group (P =.01). The incidences of total adverse events in both groups were not significantly different (28.6% vs. 25.0%, P >.05); however, two cases of ectopic embolization only occurred in the particulate group. Interestingly, medical expenditure was higher in the particulate group than in the coil group (P =.02). For the 3-year follow-up evaluation, recurrence and all-cause mortality were similar in both groups (P >.05). Preoperative embolization with coils could be relatively safe, have a lower radiation dosage and be cost-effective for the treatment of carotid body tumors.

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Carotid Body Tumours: Benign but Challenging

Cited by 6 publications

References 5 publications

Carotid Body Tumor in a 26-Year-Old Male Patient Managed With Preoperative Embolization

Carotid Body Tumor in a 26-Year-Old Male Patient Managed With Preoperative Embolization

Long-Term Surgical Outcomes of Carotid Body Tumors With Pathological Fibrosis: A Cohort Study

The Comparative Outcomes of Particulate Versus Coil Preoperative Embolization for Carotid Body Tumors

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