Clinical outcomes and challenges of surgical extirpation for carotid body tumor: A single- center case series

Abstract

Background:Carotid body tumor (CBT) is a highly vascularized, slow-growing tumor of neurovascular origin with very low incidence. Our study aimed to document the characteristics of CBTs and examine the clinical outcomes of patients’ post-surgical extirpation of CBT. Methods: This is a single-center retrospective review of patients who underwent extirpation of CBTs. We documented information concerning patient demographic characteristics, preoperative clinical features, location and size of the tumor, serum and urine catecholamine and metabolite levels, surgical procedures, and postoperative complications. Results: From September 2020 to February 2023, we examined 21 cases of CBT-removal surgery in 19 patients. The most common clinical symptom was painless swelling of the neck (n=12, 57.1%). Seven cases (33.3%) were discovered incidentally; two cases (9.6%) were discovered during the evaluation of neurologic symptoms. One female patient with bilateral CBTs had breast, bone, and lung metastases. During surgery, external carotid artery resection was performed in two cases; one primary repair of the internal carotid artery (ICA) was performed due to an ICA tear during CBT dissection. Bovine patch angioplasty with shunt insertion in the ICA was performed once. All were classified as Shamblin Ⅲ. One patient underwent incomplete resection because the CBT completely surrounded the ICA. Aspiration and hoarseness occurred most frequently as postoperative complications, followed by ipsilateral lower lip drooping, Horner’s syndrome, and first bite syndrome. Hoarseness persisted permanently in two cases (9.5%). Conclusions: Surgeons must understand the relationship between blood vessels and nerves when treating CBTs. Patients should be informed of possible cranial neuropathy resulting from surgery.