ABSTRACT
BACKGROUND: This study's objective was to conduct a multinational registry of patients with carotid body tumors (CBTs) and to analyze patients' clinical characteristics, treatments, and outcomes. METHODS: Retrospective study from the Carotid Paraganglioma Cooperative International Registry involving eleven medical centers in Bolivia, Ecuador, Mexico, and Spain, of all patients with a CBT who underwent resection between 2009 and 2019. RESULTS: A total of 1432 patients with a CBT surgically treated were included. Median patient age was 54 years (range: 45-63 years), and 82.9% (1184) of the study cohort were female. While at low altitude, the proportion of female-to-male cases was 2:1, at high altitude, this proportion increased to 8:1, with statistically significant differences (p = .022). Median operative time was 139 min (range: 110-180 min), while median operative blood loss was 250 ml (range: 100-500 ml), with statistically significant difference in increased blood loss (p = .001) and operative time (p = .001) with a higher Shamblin classification. Eight (0.6%) patients suffered stroke. Univariate analysis analyzing for possible factors associated with increased odds of stroke revealed intraoperative vascular lesion to present an OR of 2.37 [CI 95%; 1.19-4.75] (p = 0.001). In 245 (17.1%), a cranial nerve injury was reported. Seven (0.5%) deaths were recorded. CONCLUSION: The most common CBT type on this cohort was hyperplasic, which might be partially explained by the high altitudes where these patients lived. Increased blood loss and operative time were associated with a higher Shamblin classification, and the risk of stroke was associated with patients presenting transoperative vascular lesions.
Subject(s)
Carotid Body Tumor , Stroke , Carotid Body Tumor/complications , Carotid Body Tumor/pathology , Carotid Body Tumor/surgery , Female , Humans , Male , Middle Aged , Registries , Retrospective Studies , Stroke/etiology , Treatment Outcome , Vascular Surgical Procedures/adverse effectsABSTRACT
Resumen ANTECEDENTES: Entre las neoplasias epiteliales ováricas, los cistoadenomas son los más comunes y casi todos son de buen pronóstico. Pueden aparecer a cualquier edad, aunque gran parte surgen entre los 40 y 60 años. CASO CLÍNICO: Paciente de 63 años, con necrosis seca distal en el antepié derecho, con un cistoadenofibroma seroso en el ovario izquierdo que ocluía una arteria iliaca común y causó una trombosis distal que requirió intervención quirúrgica y amputación transmetatarsiana derecha. CONCLUSIÓN: El diagnóstico y tratamiento quirúrgico oportuno son decisivos para evitar la extensión de la necrosis y lograr la conservación de la mayor parte de la extremidad afectada.
Abstract BACKGROUND: Among ovarian epithelial neoplasms, cystadenomas are the most common and almost all of them have a good prognosis. They can appear at any age, although most arise between 40 and 60 years of age. CLINICAL CASE: A 63-year-old patient with distal dry necrosis in the right forefoot, with a serous cystadenofibroma in the left ovary that occluded a common iliac artery and caused a distal thrombosis that required surgical intervention and right transmetatarsal amputation. CONCLUSION: Timely diagnosis and surgical treatment are decisive to avoid the extension of necrosis and to achieve the preservation of most of the affected limb.
