Diagnosis And Treatment Of Carotid Body Tumor: 17 Cases Report

INTRODUCTION & OBJECTIVES: Carotid body tumors (CBT) are a rare and sporadical disease that should be considered in evaluating unilateral or bilateral neck mass. With modern equipment and technology improved, the clinical carotid body tumor detection rate also rose. For this condition, we evaluated the diagnosis and treatment of CBT.MATERIALS&METHODS: From 1995 to 2006, 17 patients (14 females, 3 males) ,aged 30-58 years(mean age 43.4 years old),were eventually diagnosed as CBT in our hospital. 17 patients were neck pulsatile mass for the first symptom from 4 months to 30 years in duration, other associated symptoms including swelling tenderness, dizziness, apex linguae numbness. All patients have measurements of blood chemistry and color Doppler ultrasonography. Two routine blood and urine catecholamines were measured, and CT scan 5 cases, MRI 6 cases, DSA 9 cases. 16 patients was received surgical therapy, and embolization for 2 cases. Post-operative follow-up was 2 months-6 years (mean 32.3 months).RESULTS: Routine blood and biochemical tests were no obvious abnormalities. Routine blood and urine catecholamine concentrations measured were no obvious abnormalities in 2 cases. Color Doppler ultrasonography indicated substantial hypoechoic mass in the carotid bifurcation. CT and MRI findings indicated CBT possibility, and "Lyre sign" can be obvious seen in DSA.There are 4 cases of type â… ,9 cases of type â…¡, 3 cases of typeâ…¢ by Shamblinclassification. 13 patients received tumor removed, and ipsilateral internal carotid artery repair in 1 patient, and 2 cases was received internal carotid artery reconstruction within the external carotid artery ligation. Pathological examination indicated 17 benign, 1 malignant. No deaths occurred perioperative period.,Cranial nerve palsy occurred in 5 cases. In the follow-up, there were no signs of tumor recurrence or metastasis and Cranial nerve palsy symptoms ease.CONCLUSION: In the diagnosis of CBT, CT, MR1, DSA has a higher rate of accuracy and specificity. Surgical excision should be as soon as possible after diagnosed, The protection of brain nerve are necessary in surgery. The SDH gene mutation analysis is necessary for patients and their relatives. Follow-up for patients and their relatives with the SDH gene mutations should be continuous and uninterrupted in their lives.