Contemporary presentation and evolution of management of neck paragangliomas

Kakkos, Stavros K.; Reddy, Daniel J.; Shepard, Alexander D.; Lin, Judith C.; Nypaver, Timothy J.; Weaver, Mitchell R.

doi:10.1016/j.jvs.2009.01.059

Cited by 28 publications

(40 citation statements)

References 48 publications

(111 reference statements)

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“…29) Currently embolization is recommended only for: tumors more than 5 cm in size, Shamblin's class III and those that extend significantly cranially. 30) An alternative to embolization is the insertion of a covered stent in the external carotid artery. 31) …”

Section: Discussionmentioning

confidence: 99%

Carotid Body Tumors: A Review of 25 Years Experience in Diagnosis and Management of 56 Tumors

Gad

Sayed

Elwan

et al. 2014

Annals of Vascular Diseases

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Section: Discussionmentioning

confidence: 99%

Carotid Body Tumors: A Review of 25 Years Experience in Diagnosis and Management of 56 Tumors

Gad

Sayed

Elwan

et al. 2014

Annals of Vascular Diseases

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“…7 Because of the high vascularity of these tumors and their complex anatomic location near cranial nerves and important blood vessels, resection can carry risks of blood loss and neurologic injuries. 6 The most experienced surgical centers worldwide have reported only 6 to 8 CBT resections annually, 8 so standardizing a technique is difficult. For decades, attempts to decrease the neurologic and vascular complications associated with surgery have included careful preoperative planning, the use of sensitive imaging methods, and adjunctive procedures such as embolization, stent-graft placement, and radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…For decades, attempts to decrease the neurologic and vascular complications associated with surgery have included careful preoperative planning, the use of sensitive imaging methods, and adjunctive procedures such as embolization, stent-graft placement, and radiotherapy. 8 Exposure to chronic hypoxia leads to enlargement of the carotid body from increasing glomus cell clusters and angiogenesis; this response can occur in patients with hypoxic cardiopulmonary diseases or in people who live at a high altitude, 6,9 such as in Mexico City. …”

Section: Discussionmentioning

confidence: 99%

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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“…Обычный осмотр и пальпация не позволя-ют определить топографию сонных артерий и их взаимоотношение с ПГ, протяженность и степень обрастания сосудов опухолью. В специальный ин-струментальный комплекс обследования в насто-ящее время входят УЗИ, КТ, МРТ, рентгенокон-трастное, радиоизотопное исследование, бронхо-скопия [1][2][3][4][5][6][7][8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: р а абдулгасанов з и газимагомедовunclassified

“…По мнению А. В. Покровского и соавт., плотное и пролонгированное (более 3 см) сраще-ние опухоли с ВСА следует считать показанием к ее резекции с последующим пластическим заме-щением синтетическим протезом или бедренным сегментом большой подкожной вены [10]. Парезы и параличи, обусловленные иссечени-ем вместе с ПГ черепных нервов, встречаются в 40-65 %, острое нарушение мозгового крово-обращения 2-7 %, кровотечения -до 2,5-3 % слу-чаев [1][2][3][4][5][6][7][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: рис 1 мскт каротидная пг слева рис 2 мскт того же больнunclassified

Modern principles of diagnosis and treatment paraganglioms (hemodektom ) neck

Абдулгасанов¹,

Газимагомедов²

2016

Kompleks. probl. serdečno-sosud. zabol.

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Федеральное государственное бюджетное учреждение «Научный центр сердечно-сосудистой хирургии им. А. Н. Бакулева» Российской академии наук, Москва, РоссияПредставлены современные принципы диагностики и лечения параганглиом (Пг) шеи. При анализе литературных данных выявлено, что Пг встречаются с частотой около 0,01 % от всех онкологических заболеваний головы и шеи. Этиология и патогенез заболевания до настоящего времени полностью не изучены. При диагностике Пг часто встречаются ошибки. Клиническая картина также разнообразна. Современными методами диагностики являются Кт, МРт с визуализацией сосудов головы и шеи, а также тра-диционные методы ультразвуковой диагностики и ангиография с введением контрастирующих веществ. Радикальным лечением Пг является хирургический метод. При малигнизации Пг консервативные методы лечения (химио-и радиотерапия) малоэффективны.Ключевые слова: параганглиомы (хемодектомы) шеи, артериальная гипертензия, диагностика, лечение. MODERN PRINCIPLES OF DIAGNOSIS AND TREATMENT PARAGANGLIOMS (HEMODEKTOM) NECK R. A. ABDULGASANOV, Z. I. GAZIMAGOMEDOV Federal State Budgetary Institution Bakoulev Scientific Centre for Cardiovascular Surgery Russian Academy of Sciences, Moscow, RussiaIn this review, the authors have put forward modern principles of diagnosis and treatment of paraganglioma (chemodectoma) of neck. the analysis of data in the literature revealed that paraganglioma occurs with a frequency of 0.01 % of all cancers of the head and neck. the etiology and pathogenesis of the disease is not completely understood till date. Paraganglioma is often misdiagnosed. the clinical picture is also diverse. Modern methods of diagnosis include Ct, MRI with visualization of vessels of the head and neck , as well as traditional methods like ultrasonic diagnostic angiography with the introduction of contrast medium. Radical treatment of paraganglioma includes the surgical method . When malignancy, conservative treatment (chemotherapy and radiotherapy) of paraganglioma are ineffective.Key words: paraganglioma (chemodectoma) of neck, hypertension, diagnosis and treatment.Параганглиома (ПГ) (хемодектома) -редкое заболевание области головы и шеи, составляющее 0,5-0,6 % всех опухолей этой зоны [3,15,19,24]. Среди внеорганных опухолей шеи важное место занимают опухоли нейроэктодермального генеза, к которым относятся ПГ шеи. В литературе пред-ставлен опыт лечения около 2 тыс. больных с ПГ [7, 13,15]. НЦССХ им. А. Н. Бакулева РАМН име-ет опыт лечения 47 больных с ПГ шеи. Частота ПГ среди всех онкологических заболеваний головы и шеи не превышает 0,01 % [14,25], а из обще-го числа внеорганных опухолей шеи на долю ПГ приходится 0,5-0,9 % [7, 36]. Больные с каротид-ной (КПГ) и вагальной параганглиомами (ВПГ) в этой группе составляют 15-18 % [13,35]. Ча-стота ПГ шеи встречается у женщин в 2,5-3 раза чаще, чем у мужчин [7,8,24,26].Этиология ПГ до настоящего времени полно-стью не изучена. По мнению некоторых авторов, ПГ является результатом автономного возбуж-дения хеморецепторов. Существует также точка зрения о вирусном п...

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Contemporary presentation and evolution of management of neck paragangliomas

Abstract: In the modern era, neck paragangliomas can be managed with a low incidence of long-term sequelae. Smaller, asymptomatic, and incidentally detected tumors are currently the most common presentation pattern.

Cited by 28 publications

References 48 publications

Carotid Body Tumors: A Review of 25 Years Experience in Diagnosis and Management of 56 Tumors

Carotid Body Tumors: A Review of 25 Years Experience in Diagnosis and Management of 56 Tumors

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

Modern principles of diagnosis and treatment paraganglioms (hemodektom ) neck

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