The aim of this paper is to review our experience in the diagnosis and treatment of carotid body paraganglioma [CBP] emphasizing the role of different imaging modalities and preoperative embolization.
Between 1995 and 2003 four patients with CBP were analyzed. All patients were females. Their ages ranged from 25 to 60 years. All patients presented with unilateral asymptomatic cervical mass with no family history of paragangliomas. None of the tumours were functional. One patient had preoperative palsy of the vagus, glassopharyngeal, and marginal mandibular nerves. None had evidence of distant metastasis. Three patients were living in a mountainous region. Ultrasonography [US], Doppler sonography, Computed Tomography [CT], Computer Tomography Angiography [CTA], Magnetic Resonance Imaging [MRI] Magnetic Resonance Angiography [MRA], angiography, blood pooling scan and fine needle aspiration [FNA]. Preoperative embolization was carried out for 1 patient 24 hours before surgery with 85% reduction of blood flow. Three patients had resection of the tumour and one patient required resection of the carotid arteries with a vein graft interposition. The fourth patient refused surgery. The decision to perform tumour excision or additional arterial resection was based on preoperative and intraoperative evaluation of the individual tumours. Histopathology of the resected tumours confirmed the diagnosis of CBP. Electron microscopy [EM] showed characteristic catecholamine granules. According to Shamblin classification, one patient was type 1, the second patient type II and the third patient type III. No patient developed postoperative stroke or cranial nerve palsy. The patient with Shamblin type III tumour developed postoperative neurogenic dysphagia and silent aspiration. There was no mortality. During the follow-up of eighteen months to eight years there were no recurrences, while the tumour remained the same for the patient who refused surgery
Zoheir El Hoshy ,Mosaad Abdel Aziz ,Hassan El Hoshy ,Ahmad Hesham ,
Carotid body paraganglioma,
Med. J. Cairo Univ. 2006;
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