Imaging findings of malignant bilateral carotid body tumors: A case report and review of the literature

Abstract

Abstract. Carotid body tumors (CBTs) are a rare type of extra-adrenal paraganglioma, which originate from the carotid body. A 29-year-old woman was admitted to the Department of Head and Neck Surgery, Beijing Tongren Hospital (Capital Medical University, Beijing, China) with hoarseness of the throat, which had progressively worsened over seven months. The patient had a family history of CBTs. Computed tomography and ultrasound imaging revealed multiple well-enhanced masses located at the bilateral carotid bifurcation and in the left parapharyngeal space. Surgery and pathological examination confirmed that the patient had developed regional lymph node metastasis. Significantly enhanced multiple pulmonary and hepatic lesions indicated that the patient had also developed distal metastasis. A genetic analysis performed on the family members of the patient revealed that the family carried a mutated succinate dehydrogenase D gene. In the present study, a systemic review of the literature indicated that extra vigilance is required in familial forms of CBT, in order to increase the standard of treatment for CBT patients.

Necessity of Intraoperative Level IIA Lymph Node Dissection in Patients with Carotid Body Tumors: A Retrospective Study of 126 Cases

“…MCBTs mainly metastasize to regional nodes, particularly those in the IIA region around the tumor [12]. Some CBTs can also metastasize to the lung, bone, liver, breast, pancreas, thyroid, kidney, and brain [5]. Jin et al [15] suggested that when a patient is diagnosed with MCBT, neck dissection is warranted.…”

“…MCBTs generally require postoperative radiotherapy, while chemotherapy is generally ineffective [17]. Although the malignant risk is relatively low among CBTs, all CBTs should be viewed as having malignant potential [18]. However, whether it is necessary to perform intraoperative level IIA lymph node dissection during surgery remains controversial.…”

Surgical Resection of Painless Carotid Body Tumour without Preoperative Embolization: A Case Report and Review of Literature

“…The recurrent laryngeal nerve was correctly visualized but involved in the mass. So we have not the choice to sacrifice the nerve to avoid any remaining mass tissue [8][9][10][11][12][13][14][15].…”

“…The major morbidity is related to the intraoperatively cranial nerve lesion. The risk of cranial nerve palsy as a complication of CBT surgery has been reported to range from 10% to 40% [5,15,41]. The use of clamping of all carotid arteries with placement of shunt and the immediate replacement or repair of damaged vessel, can reduce clearly massive bleeding, cerebrovascular accidents and overall morbidity [44].…”

Does Octreoscan add value in the differential diagnosis of parapharyngeal space lesions?

“…Among the possible germline mutations, those affecting succinate dehydrogenase complex iron sulfur subunit B have been associated with greater paraganglioma aggressiveness and a higher risk of metastatic disease. Despite the fact that paragangliomas are considered benign lesions, a small proportion of the affected patients develop lymph node or distant metastases ( 4 , 5 ) . In addition to their capacity for dissemination to local and distant lymph nodes, paragangliomas can metastasize to the bone, lungs, and liver by hematogenous spread.…”