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. 2014;132(3):133-9.
doi: 10.1590/1516-3180.2014.1323452. Epub 2014 Apr 14.

Carotid body tumor: retrospective analysis on 22 patients

André Luís Maion Casarim  1 , Alfio José Tincani  1 , André Del Negro  1 , Camila Guimarães Aguiar  1 , Renato Ventura Fanni  1 , Antonio Santos Martins  1
Affiliations

Carotid body tumor: retrospective analysis on 22 patients

André Luís Maion Casarim et al. Sao Paulo Med J. 2014.

Abstract
in English, Portuguese

Context and objective: Carotid body tumors, or chemodectomas, are the most common head and neck paragangliomas, accounting for 80% of the cases. They may present minor symptoms; however, they deserve special attention in order to achieve accurate diagnosis and adequate treatment. The objectives of this study were to show the approach towards chemodectomas and evaluate the complications of the patients treated surgically without previous embolization.

Design and setting: Retrospective study on chemodectomas followed up at the Head and Neck Surgery Service, Department of Surgery, Unicamp.

Methods: Twenty-two patients were evaluated between 1983 and 2009. The diagnosis was based on clinical findings and imaging methods. The epidemiological characteristics, lesion characteristics, diagnostic methods, treatment and complications were analyzed.

Results: The paragangliomas were classified as Shamblin I (9%), II (68.1%) and III (22.7%). Angiography, magnetic resonance imaging and computed tomography confirmed the diagnosis in 20 patients (90.9%). Five (22.7%) had significant bleeding during the surgery, while four (18.1%) had minor bleeding. Four patients (18.1%) developed neurological sequelae. Seven (31.8%) needed ligatures of the external carotid artery. Three patients (13.6%) underwent carotid bulb resection. The postoperative follow-up ranged from 3 months to 14 years without recurrences or mortality.

Conclusions: In our experience and in accordance with the literature, significant bleeding and neurological sequelae may occur in chemodectoma cases, particularly in Shamblin III patients. The complications from treatment without previous embolization were similar to data in the literature data, from cases in which this procedure was applied prior to surgery.

CONTEXTO E OBJETIVO:: O tumor de corpo carotídeo, ou quimiodectoma, é o paraganglioma mais comum em cabeça e pescoço, com aproximadamente 80% dos casos. Pode apresentar poucos sintomas; no entanto, necessita atenção especial para o diagnóstico e tratamento adequado. Os objetivos deste estudo são mostrar a abordagem do quimiodectoma e avaliar as complicações nos pacientes tratados cirurgicamente sem embolização prévia.

TIPO DE ESTUDO E LOCAL:: Estudo retrospectivo de quimiodectomas acompanhados pelo Serviço de Cirurgia de Cabeça e Pescoço, Departamento de Cirurgia, Unicamp.

MÉTODOS:: Vinte e dois pacientes foram avaliados entre 1983 e 2009. O diagnóstico foi baseado em achados clínicos e métodos de imagens. Foram analisados aspectos epidemiológicos, características das lesões, métodos diagnósticos, tratamento e complicações.

RESULTADOS:: Os paragangliomas foram classificados em Shamblin I (9%), II (68,1%) e III (22,7%). Angiografia, ressonância nuclear magnética e tomografia computadorizada confirmaram o diagnóstico em 20 pacientes (90,9%). Cinco (22,7%) tiveram sangramento significativo durante a cirurgia, enquanto quatro (18,1%) tiveram sangramento mínimo. Quatro pacientes (18,1%) tiveram sequelas neurológicas. Sete (31,8%) necessitaram de ligadura da artéria carótida externa. Três (13,6%) foram submetidos a ressecção do bulbo carotídeo. O acompanhamento variou de 3 meses a 14 anos, sem recorrências ou óbitos.

CONCLUSÕES:: Em nossa experiência e de acordo com a literatura, sangramentos significativos e sequelas neurológicas podem ocorrer nos quimiodectomas principalmente em pacientes Shamblin III. As complicações do tratamento sem embolização prévia foram similares aos relatos observados na literatura nos quais se aplicou tal procedimento antes da cirurgia.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Tumor mass dissected at the carotid bifurcation. (A) Arrow shows carotid body tumor. (B) Preserved carotid arteries (arrows) after resection of carotid body tumor
Figure 2
Figure 2. Computed tomography showing left parapharyngeal tumor (arrow)
Figure 3
Figure 3. Magnetic resonance angiography with three-dimensional reconstruction, showing a vascular mass at the carotid bifurcation (arrow)
Figure 4
Figure 4. Angiography showing vascular mass at the carotid bifurcation (arrow)
Graph 1
Graph 1. Intraoperative bleeding according to Shamblin classification
Graph 2
Graph 2. Neurological sequelae according to Shamblin classification
See this image and copyright information in PMC

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