Carotid body tumors: challenging complexity of diagnosis and surgical management

ABSTRACT

The tumor of the carotid body tumor [CBT], is a rare tumor, only about 1000 cases had been reported in the literature. It's of obscure origin and misdiagnosed if it is suspected. CBT is usually benign and commonly presented as a non-painful cervical mass. The aim of this study was to analyze diagnostic and therapeutic aspects and complications of surgery of CBT in Mansoura University Hospitals. We present eight patients had 10 carotid body tumor. Male to female ratio was [1 2], age ranged between 13-72 years in the period between May 2000 to December 2003. The aim of this study was to analyze diagnostic and therapeutic aspect and complications of surgery of CBT in Mansoura University Hospitals. All patients were identified and complete radiological study was done including CT, MRI, Doppler Ultrasound and Angiography. Clinically, there were no secreting tumors in these patients. Preoperative immobilization was done in seven cases 24hours before surgery. All patient were operated on for tumor resection. Result the blood loss for these patients was fewer than those without immobilization. Only one case needed resection of the carotid and interposition graft. One patient had preoperative nerve deficit. Neurological deficits were noted in three patients out of nine patients [33%] immediately after surgery and two patients out of seven had permanent deficit [29%]. One patient deceased in the postoperative period from pulmonary embolism [12.5%]. Our conclusion is the diagnosis of CBT is depending on suspicious, radiology is essential. Embolization decreases blood loss and facilitates tumor removal. Observation is not recommended because of the progressive behavior of the tumor associated with increased risk of neurological deficit. Surgery is the treatment of choice with minimal morbidity and mortality