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Synchronous bilateral carotid body tumor and vagal paraganglioma: A
case report and review of literature.Auris
Nasus Larynx. 2007 Sep 10
We present a
case of synchronous bilateral carotid body tumor and vagal
paraganglioma in a 49-year-old man who presented with 3 months
history of tenderness and palpable neck masses bilaterally. An
encapsulated mass which was thought to be a carotid body tumor and
an incidental 3cmx2cm, 5cmx1cm, 5cm mass which seemed to be
originated from vagus nerve were dissected from the left side.
Pathology revealed carotid body tumor and vagal paraganglioma. Six
months after the first operation, the carotid body tumor on the
right side was totally excised. A discussion of this case is
followed by a review of the literature surrounding this rare clinic
and pathological entity.
Carotid body
tumors: review of a 20-year experience.Oral
Oncol. 2005 Jan;41(1):56-61.
Carotid body
tumors (CBT) are a rare entity that should be considered in
evaluating every lateral neck mass. The objective of the study was
to compare demographic data, complications and evolution of patients
treated at our institution. A retrospective study was made of 66
patients with 69 CBT that were treated at our institution between
1982 and 2002. We reviewed the demographic characteristics, clinical
features, surgical approach and complications. Women significantly
predominated (96.9%) with a female:male ratio of 31.2:1. Ages ranged
from 18 to 94 (mean=50.2). Fifty-four per cent of the patients lived
at altitudes higher than 2200 m above sea level. The most common
chief complaint was a painless neck mass (78.7%). No patient had any
malignant tumors or a familial history of CBT. Both sides were
similarly affected. There were four tumors grouped in Shamblin's
class I, 24 in class II, and 35 in class III. Six tumors were of
undetermined Shamblin's class as inferred from their medical
records. Fifty-three patients received treatment: 46 (86.8%),
surgery; 6 (11.3%), radiotherapy; 1 (1.9%), radiotherapy following
surgery. Three patients (6.3%) underwent vascular reconstruction. In
23 (49%) patients neurological deficit was observed after surgery.
Minor complications occurred in five (10.6%) patients. Median
follow-up was 38 months, one patient died from a cause not related
to the CBT, and the rest remain disease-free and asymptomatic. We
found an overwhelming predominance of women, which opens the
possibility that we are dealing with a different disease in female
Latin populations. Most of the tumors were of Shamblin's class III
CBT. Early surgical management is recommended to avoid neurological
deficit due to a Shamblin's class III tumor.
Malignant
carotid paraganglioma. A case report.
Ann Otolaryngol Chir Cervicofac .
2003 Apr;120(2):103-8.
The most
common sites of paragangliomas occurring in the head and neck region
are the carotid body and vagal glomus. The clinical course of
carotid body paragangliomas is characterized by two modes of
development: locoregional growth and distant metastatic
dissemination. Few cases of malignant carotid body paraganglioma
have been reported in the literature. We report a case managed in
the ENT Department of Grenoble university hospital in 1993. A
53-year-old woman presented a bilateral functional (dopamine
secretion) carotid tumor, stage II on the right side and stage I on
the left side according to the Shamblin classification. Two
successive excisions with complete resection were performed without
complication. Two years after the second surgical excision, bone and
liver metastases were diagnosed and visualized with a Ostreoscan
scintigraphy. Clinical course was rapidly unfavorable and the
patient died a few weeks later. Malignant forms of carotid
paraganglioma are very uncommon and there is no cellular or
histological appearance significantly contributing to the diagnosis
of malignancy. Clinical findings are the most reliable criteria for
malignancy, with the development of distant metastases usually after
about 9 years. Long follow-up is essential. Histology in needed to
establish the diagnosis of metastasis. A histology specimen may not
be possible for a functional paraganglioma. In this case
scintigraphy can provide the diagnosis. Malignant forms are more
frequent in case of functional paraganglioma, more particularly in
case of dopamine secretion.
Cytologic
findings in carotid body tumors.
Acta Cytol. 2002 Nov-Dec;46 (6): 1101-4.
OBJECTIVE:
To describe the cytologic findings in 13 cases of carotid body
tumors (CBTs) and discuss the differential diagnoses. STUDY DESIGN:
Cytologic smears were obtained from 13 cases of carotid body tumors
by fine needle aspiration. All tumors were clinically suspected and
later confirmed by arteriography or color Doppler ultrasonography.
The cytomorphologic findings are described. RESULTS: The smears
revealed hypercellularity, a bloody background, isolated and
clusters of round to oval cells with indistinct cytoplasm, reticular
chromatin, no prominent nucleoli, giant bare nuclei, anisocytosis,
acinar structures and plasmacytoid cells. These findings suggested
metastatic tumors. CONCLUSION: The cytologic diagnosis of CBTs is
very difficult. The aspiration findings can be easily mistaken for
those of metastatic tumors. However, when used with clinical and
color Doppler findings, fine needle aspiration plays an important
role in the preoperative diagnosis and management of CBTs.
Management of
carotid body paragangliomas and review of a 30-year experience.
Ann Vasc Surg. 2002 May;16(3):331-8.
Carotid body
tumors are rare neoplasms and must be considered in the evaluation
of all lateral neck masses; early surgical removal has been
recommended. In this study, the medical records of 29 patients with
34 carotid body paragangliomas who were treated at our institution
between 1971 and 2001 were retrospectively reviewed. An overview is
provided of this lesion, including diagnosis, classification,
metastatic potential, possible secretory function, operative
techniques, and nonsurgical methods of management. Carotid body
tumors may be familial and are more often bilateral in these
instances; five patients (17%) had bilateral tumors in this series.
The criterion for malignancy is demonstrated by metastatic tumor in
lymph nodes or distant organs. Three patients (10%) had malignant
tumors, one with hepatic metastases. One patient (3%) in our series
exhibited abnormal serotonin production. Vascular reconstruction was
necessary in eight cases (28%). No stroke occurred, however, two
arterial thromboses (7%), five permanent cranial nerve deficits
(17%), and one death (3%) from massive pulmonary embolism were seen.
Our experience demonstrates that early operative management is
warranted to avoid the possibility of eventual metastasis and
progressive local invasion to the point of inoperability.
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