Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Jianqiang , LI Chengjin , ZHANG Zaizhong , WANG Lie ,  CHEN Jianwei

Department of General Surgery, Fuzhou General Hospital of The Chinese People’s Liberation Army, Fuzhou 350025, P. R. China;

Corresponding?author：

CHEN Jianwei, Email: myself008@126.com

Keywords：

carotid body tumor; diagnosis; treatment; complication

DOI：

10.7507/1007-9424.201707091

Video：

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Objective To sum up the diagnosis, treatment, and prevention of postoperative complications of carotid body tumor. Methods The clinical data of 27 patients (30 aneurysms) with carotid body tumor who treated in our hospital from June 2005 to June 2016 were analyzed retrospectively. Results Of the 27 patients, 24 patients had unilateral lesions and 3 patients had bilateral lesions, with a total of 30 aneurysms. Three patients received color Doppler ultrasound, 18 patients received computed tomography angiography, 3 patients received magnetic resonance angiography, and 6 patients received digital subtraction angiography. According to Shamblin classification: 10 aneurysms belonged to typeⅠ, 16 aneurysms belonged to typeⅡ, 4 aneurysms belonged to type Ⅲ. Twenty aneurysms were treated with simple stripping, 6 aneurysms were treated with tumor resection and external carotid artery resection, 2 aneurysms were resected by resection, partial carotid artery resection plus external-internal carotid artery anastomosis, 2 aneurysms were resected by resection, resection of internal carotid artery, external carotid artery, and common carotid artery, as well as internal carotid artery-common carotid artery bypass. All patients underwent a successful operation with no death. After surgery,1 patient suffered from hemiplegia, 2 patients suffered from hoarseness, and 1 patient suffered from cough. Of the 27 patients, 24 patients were followed-up from 3 months to 4 years, with a median time of 2.3 years. During the follow-up procedure, the 1 patient with hemiplegic recovered to more than three levels of muscle strength after 6 months after rehabilitation, the 2 patients with hoarseness and 1 patient with cough returned to normal after 2 months after symptomatic treatment. There was no recurrence during follow-up procedure, and no other complications occurred. Conclusion Computed tomography angiography and magnetic resonance angiography are propitious to the definitive diagnosis of carotid body tumor, and actively surgical treatment should be performed once diagnosis of carotid body tumor.

Citation： HUANG Jianqiang, LI Chengjin, ZHANG Zaizhong, WANG Lie, CHEN Jianwei. Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(1): 48-53. doi: 10.7507/1007-9424.201707091 Copy

1.	李冬林, 趙渝. 頸動脈體瘤的外科治療. 中國血管外科雜志(電子版), 2013, 5(2): 94-96.
2.	Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
3.	Unlü Y, Becit N, Ceviz M, et al. Management of carotid body tumors and familial paragangliomas: review of 30 years’ experience. Ann Vasc Surg, 2009, 23(5): 616-620.
4.	Shamblin WR, ReMine WH, Sheps SG, et al. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg, 1971, 122(6): 732-739.
5.	Nishijima H, Asakage T, Sugasawa M. Malignant carotid body tumor with systemic metastases. Ann Otol Rhinol Laryngol, 2011, 120(6): 381-385.
6.	黃志剛, 郭偉, 寇秀娟, 等. 頸動脈體瘤家系琥珀酸脫氫酶 D 亞單位基因截短體 R38X 質粒構建和體外功能驗證. 中國耳鼻咽喉頭頸外科, 2014, 21(2): 57-60.
7.	Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
8.	Lian LS, Liu CW, Guan H, et al. Efficacy of surgical therapy for carotid body tumors. Chin Med Sci J, 2011, 26(4): 241-245.
9.	劉翠, 許春偉, 王晶晶, 等. 頸動脈體瘤臨床病理分析并文獻復習. 解放軍醫藥雜志, 2015, 27(2): 103-106.
10.	戈小虎. 頸動脈體瘤的診療進展. 國際外科學雜志, 2013, 40(12): 793-796.
11.	佘志強, 劉繼遠. 頸動脈體瘤的診治進展. 國際耳鼻咽喉頭頸外科雜志, 2016, 40(3): 168-172.
12.	陳曉紅, 房居高, 張洋, 等. ShamblinⅢ型頸動脈體瘤手術治療. 中國耳鼻咽喉頭頸外科, 2012, 19(6): 289-292.
13.	胡敏, 張立海, 楊舸, 等. 選擇性血管栓塞術輔助頸動脈體瘤切除術. 華西口腔醫學雜志, 2010, 28(4): 387-390.
14.	Patlola R, Ingraldi A, Walker C, et al. Carotid body tumor. Int J Cardiol, 2010, 143(1): e7-e10.
15.	Gemmete JJ, Pandey AS, Chaudhary N, et al. Paradoxical embolus to the brain from embolization of a carotid body tumor. J Neurointerv Surg, 2012, 4(4): e12.
16.	Demir T, Uyar I, Demir HB, et al. Five-year follow-up of a patient with bilateral carotid body tumors after unilateral surgical resection. Am J Case Rep, 2014, 15: 426-430.
17.	唐軍, 張磊, 李繼軍, 等. 頭頸部富血供腫瘤的術前栓塞治療. 中華介入放射學電子雜志, 2014, 2(1): 5-7.
18.	Power AH, Bower TC, Kasperbauer J, et al. Impact of preoperative embolization on outcomes of carotid body tumor resections. J Vasc Surg, 2012, 56(4): 979-989.
19.	Bercin S, Muderris T, Sevil E, et al. Efficiency of preoperative embolization of carotid body tumor. Auris Nasus Larynx, 2015, 42(3): 226-230.
20.	戚悠飛, 肖占祥, 曾昭凡, 等. 頸動脈體瘤的診斷與外科治療. 臨床外科雜志, 2012, 20(8): 554-556.
21.	葉茂昌, 王來平, 李容新, 等. 超聲刀在頸淋巴清掃術中的臨床應用. 口腔頜面外科雜志, 2014, 24(1): 35-38.
22.	馮亞茹, 陳曉紅, 寇秀娟, 等. 雙側頸動脈體瘤的個體化治療. 中華耳鼻咽喉頭頸外科雜志, 2017, 52(1): 37-43.
23.	Sen I, Stephen E, Malepathi K, et al. Neurological complications in carotid body tumors: a 6-year single-center experience. J Vasc Surg, 2013, 57(2 Suppl): 64S-68S.
24.	蔣京軍, 張學民, 李偉, 等. 雙側頸動脈體瘤的手術治療. 中華普通外科雜志, 2015, 30(1): 35-37.
25.	李武, 田皞, 喻建軍, 等. 雙頸動脈體瘤術后壓力感受器衰竭綜合征一例. 中華耳鼻咽喉頭頸外科雜志, 2014, 49(9): 779-780.
26.	Ghali MGZ, Srinivasan VM, Hanna E, et al. Overt and Subclinical Baroreflex Dysfunction After Bilateral Carotid Body Tumor Resection: Pathophysiology, Diagnosis, and Implications for Management. World Neurosurg, 2017, 101: 559-567.

1. 李冬林, 趙渝. 頸動脈體瘤的外科治療. 中國血管外科雜志(電子版), 2013, 5(2): 94-96.
2. Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
3. Unlü Y, Becit N, Ceviz M, et al. Management of carotid body tumors and familial paragangliomas: review of 30 years’ experience. Ann Vasc Surg, 2009, 23(5): 616-620.
4. Shamblin WR, ReMine WH, Sheps SG, et al. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg, 1971, 122(6): 732-739.
5. Nishijima H, Asakage T, Sugasawa M. Malignant carotid body tumor with systemic metastases. Ann Otol Rhinol Laryngol, 2011, 120(6): 381-385.
6. 黃志剛, 郭偉, 寇秀娟, 等. 頸動脈體瘤家系琥珀酸脫氫酶 D 亞單位基因截短體 R38X 質粒構建和體外功能驗證. 中國耳鼻咽喉頭頸外科, 2014, 21(2): 57-60.
7. Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
8. Lian LS, Liu CW, Guan H, et al. Efficacy of surgical therapy for carotid body tumors. Chin Med Sci J, 2011, 26(4): 241-245.
9. 劉翠, 許春偉, 王晶晶, 等. 頸動脈體瘤臨床病理分析并文獻復習. 解放軍醫藥雜志, 2015, 27(2): 103-106.
10. 戈小虎. 頸動脈體瘤的診療進展. 國際外科學雜志, 2013, 40(12): 793-796.
11. 佘志強, 劉繼遠. 頸動脈體瘤的診治進展. 國際耳鼻咽喉頭頸外科雜志, 2016, 40(3): 168-172.
12. 陳曉紅, 房居高, 張洋, 等. ShamblinⅢ型頸動脈體瘤手術治療. 中國耳鼻咽喉頭頸外科, 2012, 19(6): 289-292.
13. 胡敏, 張立海, 楊舸, 等. 選擇性血管栓塞術輔助頸動脈體瘤切除術. 華西口腔醫學雜志, 2010, 28(4): 387-390.
14. Patlola R, Ingraldi A, Walker C, et al. Carotid body tumor. Int J Cardiol, 2010, 143(1): e7-e10.
15. Gemmete JJ, Pandey AS, Chaudhary N, et al. Paradoxical embolus to the brain from embolization of a carotid body tumor. J Neurointerv Surg, 2012, 4(4): e12.
16. Demir T, Uyar I, Demir HB, et al. Five-year follow-up of a patient with bilateral carotid body tumors after unilateral surgical resection. Am J Case Rep, 2014, 15: 426-430.
17. 唐軍, 張磊, 李繼軍, 等. 頭頸部富血供腫瘤的術前栓塞治療. 中華介入放射學電子雜志, 2014, 2(1): 5-7.
18. Power AH, Bower TC, Kasperbauer J, et al. Impact of preoperative embolization on outcomes of carotid body tumor resections. J Vasc Surg, 2012, 56(4): 979-989.
19. Bercin S, Muderris T, Sevil E, et al. Efficiency of preoperative embolization of carotid body tumor. Auris Nasus Larynx, 2015, 42(3): 226-230.
20. 戚悠飛, 肖占祥, 曾昭凡, 等. 頸動脈體瘤的診斷與外科治療. 臨床外科雜志, 2012, 20(8): 554-556.
21. 葉茂昌, 王來平, 李容新, 等. 超聲刀在頸淋巴清掃術中的臨床應用. 口腔頜面外科雜志, 2014, 24(1): 35-38.
22. 馮亞茹, 陳曉紅, 寇秀娟, 等. 雙側頸動脈體瘤的個體化治療. 中華耳鼻咽喉頭頸外科雜志, 2017, 52(1): 37-43.
23. Sen I, Stephen E, Malepathi K, et al. Neurological complications in carotid body tumors: a 6-year single-center experience. J Vasc Surg, 2013, 57(2 Suppl): 64S-68S.
24. 蔣京軍, 張學民, 李偉, 等. 雙側頸動脈體瘤的手術治療. 中華普通外科雜志, 2015, 30(1): 35-37.
25. 李武, 田皞, 喻建軍, 等. 雙頸動脈體瘤術后壓力感受器衰竭綜合征一例. 中華耳鼻咽喉頭頸外科雜志, 2014, 49(9): 779-780.
26. Ghali MGZ, Srinivasan VM, Hanna E, et al. Overt and Subclinical Baroreflex Dysfunction After Bilateral Carotid Body Tumor Resection: Pathophysiology, Diagnosis, and Implications for Management. World Neurosurg, 2017, 101: 559-567.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases

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