Successful treatment of a rare metastatic malignant carotid body tumour in a young adult, with conservative surgery and local radiotherapy

Williamson, John S.; Leopold, George R.; Prabhu, Vinod; Ingrams, Duncan R.

doi:10.1017/s0022215111002994

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…There are also reports of carotid and vertebral artery dissections leading to hypoglossal nerve injury. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] In a large case series of hypoglossal nerve palsies, the site of the lesion could not be localized in 6%. 9 In the radiologic diagnostic work-up, a segmental imaging approach is advised.…”

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confidence: 99%

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

Meng¹,

Reissig²,

Tzou

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The hypoglossal nerve, providing motor innervation for the tongue, can be affected in many diseases of the neck and skull base, leading to dysarthria, dysphagia, and ultimately atrophy of the tongue. We determined the feasibility of direct visualization of the hypoglossal nerve in the neck with ultrasound, testing this technique on healthy volunteers and evaluating it in clinical practice.

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confidence: 99%

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

Meng¹,

Reissig²,

Tzou

et al. 2015

AJNR Am J Neuroradiol

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“…Among these articles, 20 (158 patients) included 5 or more patients (Table 1) 18–39 and were considered for the proportion MA. The remaining 112 studies (179 patients), represented by case reports or case series with <5 patients, are reported in Table S1 3,40–152 …”

Section: Resultsmentioning

confidence: 99%

“…For proportion meta‐analysis (MA), only case series with at least five consecutive cases were considered (Table 1). 18–39 All the other case series describing less than five patients (including case reports) were considered only for the SR and detailed in Table S1 3,40–152 …”

Section: Methodsmentioning

confidence: 99%

Malignant carotid body tumors: What we know, what we do, and what we need to achieve. A systematic review of the literature

Piazza,

Lancini,

Tomasoni

et al. 2024

Head & Neck

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Malignant carotid body tumors (MCBT) are rare and diagnosed after detection of nodal or distant metastases. This systematic review (SR) focuses on MCBT initially approached by surgery. Preferred Reporting Items for SR and Meta‐Analysis (MA) guided the articles search from 2000 to 2023 on PubMed, Scopus, and Web of Science. Among 3548 papers, 132 (337 patients) were considered for SR; of these, 20 (158 patients) for MA. Malignancy rate was 7.3%, succinate dehydrogenase (SDH) mutation 17%, age at diagnosis between 4th and 6th decades, with a higher prevalence of females. MCBTs were mostly Shamblin III, with nodal and distant metastasis in 79.7% and 44.7%, respectively. Malignancy should be suspected if CBT >4 cm, Shamblin III, painful or otherwise symptomatic, at the extremes of age, bilateral, with multifocal disease, and SDHx mutations. Levels II–III clearance should be performed to exclude nodal metastases and adjuvant treatments considered on a case‐by‐case basis.

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“…These tumors can occur at any age with an equal division between the two genders. However, the literature suggests that it most commonly presents in the fifth decade 2 , 21 . Presentation at a younger age can occur in individuals that carry genetic mutations in the succinate dehydrogenase subunit B gene (SDHB) or succinate dehydrogenase subunit D gene (SDHD) 3 .…”

Section: Discussionmentioning

confidence: 99%

“…A biopsy of the tumor is contra-indicated as it carries the risk of massive hemorrhage, thrombosis, pseudoaneurysm formation, and dissemination 19 , 20 . Surgical resection of the CBT is the treatment of choice with or without adjuvant radiotherapy 21 . Lymph node sampling should be performed during primary resection 22 .…”

Section: Introduction and Importancementioning

confidence: 99%

Malignant carotid body tumor: a report of two cases

Alfawaz

Albloushi

Quttaineh

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Carotid body tumors (CBT) are neoplasms that originate from chemoreceptors of the carotid body. They are neuroendocrine tumors that are usually benign but may have malignant potential. Malignancy is diagnosed with evidence of lymph node metastasis, distant metastasis, or disease recurrence. Multiple imaging modalities are used to diagnose CBTs and the treatment of choice is surgical excision. Radiotherapy is used for unresectable tumors. In this case, series we describe two cases of malignant paragangliomas that were diagnosed and operated on at a tertiary hospital in Kuwait, by the vascular team. Malignant CBTs are rare, documentation of the cases encountered and the subsequent management and outcome is important to give us a better understanding of the disease. Case presentation: Case one– A 23-year-old woman presented with a right-sided neck mass. History, physical examination, and appropriate imaging suggested malignant paraganglioma with evidence of lymph node, vertebral, and lung metastases. Surgical excision of the tumor and regional lymph nodes was done. Histopathological assessment of the retrieved specimens confirmed the diagnosis. Case two – A 29-year-old woman presented with a left submandibular swelling. She was appropriately investigated, and the diagnosis of a malignant carotid body tumor was made with evidence of lymph node metastasis. Surgical resection of the tumor with clear margins was done and histopathological analysis of the resected specimen confirmed the diagnosis. Clinical discussion: CBT’s are the most common tumors of the head and neck. Most are nonfunctioning, slow growing, and benign. They typically present in the fifth decade of life but can occur at a younger age in individuals who carry certain genetic mutations. Both cases of malignant CBT’s that we encountered occurred in young women. Furthermore, the 4-year and 7-year history in case number one and two, respectively, supports the fact that CBTs are slow growing tumors. In our case series, the tumors were surgically resected. Both cases were discussed in multidisciplinary meetings and were referred for hereditary testing and radiation oncology for further management. Conclusion: Malignant carotid body tumors are rare. Prompt diagnosis and treatment is important to improve patient outcomes.

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Successful treatment of a rare metastatic malignant carotid body tumour in a young adult, with conservative surgery and local radiotherapy

Abstract: Malignant carotid body paraganglioma can affect young adults, with an insidious onset of symptoms. In this patient, local excision (without neck dissection) and adjuvant radiotherapy were well tolerated and resulted in satisfactory local disease control.

Cited by 6 publications

References 11 publications

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

Malignant carotid body tumors: What we know, what we do, and what we need to achieve. A systematic review of the literature

Malignant carotid body tumor: a report of two cases

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