Skip to main content

Advertisement

SpringerLink
Log in

Carotid body tumor: a 25-year experience

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Carotid body tumor is an uncommon hypervascular benign tumor in the head and neck region. It usually presents as a slow growing mass at the carotid bifurcation. Because of the high rate of neurovascular complications, resection of this tumor is considered challenging for otolaryngologists. Between 1988 and 2013, 40 carotid body tumors from 38 patients were diagnosed and underwent resection at Siriraj Hospital (25 female and 13 male patients). Their age ranged from 15 to 59 years. Seven patients had bilateral tumors simultaneously whereas six cases had familial history of carotid body tumor. Carotid angiography was performed in 29 cases; other additional diagnostic studies included CT scan, MRI, and MRA to detect the widening of carotid bifurcation, its extension, and multifocal tumors. All diagnosed tumors were successfully removed. However, internal carotid artery and carotid bifurcation were injured in 11 cases (27.5 %). Shamblin class III and previous biopsy history were considered risk factors for vascular injury. Postoperative cranial nerves deficit was found in 20 % of the cases and CNS complication occurred in two patients (5 %). There was no surgical mortality. Additionally, upon the mean follow-up period of 36 months, no recurrence or malignant transformation was detected in this study. Multidisciplinary approach, early tumor detection, meticulous preoperative evaluation, and modern vascular surgical technique are the key success factors for tumor removal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shamblin WR, ReMine WH, Sheps SG, Harrison EG Jr (1971) Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg 122:732–739

    Article  CAS  PubMed  Google Scholar 

  2. Ward PH, Jenkins HA, Hanafee WN (1978) Diagnosis and treatment of carotid body tumors. Ann Otol Rhinol Laryngol 87:614–621

    Article  CAS  PubMed  Google Scholar 

  3. Mena J, Bowen JC, Hollier LH (1993) Metachronous bilateral nonfunctional intercarotid paraganglioma (carotid body tumor) and functional retroperitoneal paraganglioma: report of a case and review of the literature. Surgery 114:107–111

    CAS  PubMed  Google Scholar 

  4. Papaspyrou K, Mann WJ, Amedee RG (2009) Management of head and neck paragangliomas: review of 120 patients. Head Neck 31:381–387

    Article  PubMed  Google Scholar 

  5. Williams MD, Phillips MJ, Nelson WR, Rainer WG (1992) Carotid body tumor. Arch Surg 127:963–967

    Article  CAS  PubMed  Google Scholar 

  6. Warshawski SJ, de Souza FM (1989) The carotid body tumor. J Otolaryngol 18:306–310

    CAS  PubMed  Google Scholar 

  7. Kraus DH, Sterman BM, Hakaim AG, Beven EG, Levine HL, Wood BG et al (1990) Carotid body tumors. Arch Otolaryngol Head Neck Surg 116:1384–1387

    Article  CAS  PubMed  Google Scholar 

  8. Bernard RP (1992) Carotid body tumors. Am J Surg 163:494–496

    Article  CAS  PubMed  Google Scholar 

  9. Sanghvi VD, Chandawarkar RY (1993) Carotid body tumors. J Surg Oncol 54:190–192

    Article  CAS  PubMed  Google Scholar 

  10. Davidovic L, Ilic N, Dimitrijevic M, Dukic V, Dzodic R (2008) Surgical management of cervical paragangliomas. Am Surg 74:1171–1176

    PubMed  Google Scholar 

  11. Makeieff M, Raingeard I, Alric P, Bonafe A, Guerrier B, Marty-Ane C (2008) Surgical management of carotid body tumors. Ann Surg Oncol 15:2180–2186

    Article  CAS  PubMed  Google Scholar 

  12. Sajid MS, Hamilton G, Baker DM (2007) A multicenter review of carotid body tumour management. Eur J Vasc Endovasc Surg 34:127–130

    Article  CAS  PubMed  Google Scholar 

  13. Knight TT Jr, Gonzalez JA, Rary JM, Rush DS (2006) Current concepts for the surgical management of carotid body tumor. Am J Surg 191:104–110

    Article  PubMed  Google Scholar 

  14. Padberg FT Jr, Cady B, Persson AV (1983) Carotid body tumor. The Lahey Clinic experience. Am J Surg 145:526–528

    Article  PubMed  Google Scholar 

  15. Robison JG, Shagets FW, Beckett WC Jr, Spies JB (1989) A multidisciplinary approach to reducing morbidity and operative blood loss during resection of carotid body tumor. Surg Gynecol Obstet 168:166–170

    CAS  PubMed  Google Scholar 

  16. Kasper GC, Welling RE, Wladis AR, CaJacob DE, Grisham AD, Tomsick TA et al (2006) A multidisciplinary approach to carotid paragangliomas. Vasc Endovascular Surg 40:467–474

    Article  PubMed  Google Scholar 

  17. Dardik A, Eisele DW, Williams GM, Perler BA (2002) A contemporary assessment of carotid body tumor surgery. Vasc Endovascular Surg 36:277–283

    Article  PubMed  Google Scholar 

  18. van den Berg R (2005) Imaging and management of head and neck paragangliomas. Eur Radiol 15:1310–1318

    Article  PubMed  Google Scholar 

  19. Kohler HF, Carvalho AL, Mattos Granja NV, Nishinari K, Kowalski LP (2004) Surgical treatment of paragangliomas of the carotid bifurcation: results of 36 patients. Head Neck 26:1058–1063

    Article  PubMed  Google Scholar 

  20. Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO et al (2004) Paragangliomas of the head and neck. Oral Oncol 40:563–575

    Article  PubMed  Google Scholar 

  21. Bhavakula K, Suphaphongs N, Koompong P, Varakitpokatorn P, Lurngnatestape A, Swai-Sewee P et al (1992) Carotid Body Tumor Resection and hypotensive Anesthesia During 1985–1991 Siriraj. Hosp Gaz 44:199–204

    Google Scholar 

  22. Amato B, Bianco T, Compagna R, Siano M, Esposito G, Buffone G et al (2014) Surgical resection of carotid body paragangliomas: 10 years of experience. Am J Surg 207:293–298

    Article  PubMed  Google Scholar 

  23. Vogel TR, Mousa AY, Dombrovskiy VY, Haser PB, Graham AM (2009) Carotid body tumor surgery: management and outcomes in the nation. Vasc Endovascular Surg 43:457–461

    Article  PubMed  Google Scholar 

  24. Netterville JL, Reilly KM, Robertson D, Reiber ME, Armstrong WB, Childs P (1995) Carotid body tumors: a review of 30 patients with 46 tumors. Laryngoscope 105:115–126

    Article  CAS  PubMed  Google Scholar 

  25. Trimas SJ, Mancuso A, de Vries EJ, Cassisi NJ (1994) Avascular carotid body tumor. Otolaryngol Head Neck Surg 110:131–135

    Article  CAS  PubMed  Google Scholar 

  26. Luna-Ortiz K, Rascon-Ortiz M, Villavicencio-Valencia V, Granados-Garcia M, Herrera-Gomez A (2005) Carotid body tumors: review of a 20 year experience. Oral Oncol 41:56–61

    Article  PubMed  Google Scholar 

  27. Hinerman RW, Mendenhall WM, Amdur RJ, Stringer SP, Antonelli PJ, Cassisi NJ (2001) Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body, and glomus vagale. Head Neck 23:363–371

    Article  CAS  PubMed  Google Scholar 

  28. Gujrathi CS, Donald PJ (2005) Current trends in the diagnosis and management of head and neck paragangliomas. Curr Opin Otolaryngol Head Neck Surg 13:339–342

    Article  PubMed  Google Scholar 

  29. Paris J, Facon F, Thomassin JM, Zanaret M (2006) Cervical paragangliomas: neurovascular surgical risk and therapeutic management. Eur Arch Otorhinolaryngol 263:860–865

    Article  CAS  PubMed  Google Scholar 

  30. Singh D, Pinjala RK, Reddy RC, Satya Vani PV (2006) Management for carotid body paragangliomas. Interact CardioVasc Thorac Surg 5:692–695

    Article  PubMed  Google Scholar 

  31. Chamorro Sanchez A, Varela de Seijas E, Matesanz Matesanz J, Trapero VL (1988) Carotid body tumor: unusual cause of transient ischemic attacks. Stroke 19:102–103

    Article  CAS  PubMed  Google Scholar 

  32. Nunez DA, Lang W, Pollock JG (1989) Associated carotid body tumour and pharyngeal pouch. J Laryngol Otol 103:531–532

    Article  CAS  PubMed  Google Scholar 

  33. Anand VK, Alemar GO, Sanders TS (1995) Management of the internal carotid artery during carotid body tumor surgery. Laryngoscope 105:231–235

    Article  CAS  PubMed  Google Scholar 

  34. Persky MS, Setton A, Niimi Y, Hartman J, Frank D, Berenstein A (2002) Combined endovascular and surgical treatment of head and neck paragangliomas–a team approach. Head Neck 24:423–431

    Article  PubMed  Google Scholar 

  35. Olsen WL, Dillon WP, Kelly WM, Norman D, Brant-Zawadzki M, Newton TH (1987) MR imaging of paragangliomas. AJR Am J Roentgenol 148:201–204

    Article  CAS  PubMed  Google Scholar 

  36. Kapoor R, Saha MM, Das DK, Gupta AK, Tyagi S (1989) Carotid body tumor initially diagnosed by fine needle aspiration cytology. Acta Cytol 33:682–683

    CAS  PubMed  Google Scholar 

  37. Avgerinos ED, Moulakakis K, Brountzos E, Giannakopoulos TG, Lazaris AM, Koumarianou A et al (2011) Advances in assessment and management of carotid body tumors. Vascular 19:250–256

    Article  PubMed  Google Scholar 

  38. Paridaans MP, van der Bogt KE, Jansen JC, Nyns EC, Wolterbeek R, van Baalen JM et al (2013) Results from craniocaudal carotid body tumor resection: should it be the standard surgical approach? Eur J Vasc Endovasc Surg 46:624–629

    Article  CAS  PubMed  Google Scholar 

  39. Kalani MY, Ducruet AF, Crowley RW, Spetzler RF, McDougall CG, Albuquerque FC (2013) Transfemoral transarterial onyx embolization of carotid body paragangliomas: technical considerations, results, and strategies for complication avoidance. Neurosurgery 72:9–15

    Article  PubMed  Google Scholar 

  40. Zeitler DM, Glick J, Har-El G (2010) Preoperative embolization in carotid body tumor surgery: is it required? Ann Otol Rhinol Laryngol 119:279–283

    PubMed  Google Scholar 

  41. Ferguson GG (1986) Carotid endarterectomy. To shunt or not to shunt? Arch Neurol 43:615–617

    Article  CAS  PubMed  Google Scholar 

  42. Li-shan L, Chang-wei L, Heng G, Yue-hong Z, Xing-ming C, Yong-jun L (2011) Efficacy of surgical therapy for carotid body tumors. Chin Med Sci J26:241–245

    Google Scholar 

  43. Thabet MH, Kotob H (2001) Cervical paragangliomas: diagnosis, management and complications. J Laryngol Otol 115:467–474

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The author would like to thank Drs. Somchai Sriyoschati and Teeravit Panchaipetch for their contribution in patient care; Jeerapa Kerdnoppakhun for manuscript assistance; and Dr. Chulaluk Komoltri for statistical advices.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Phrannok Road, Bangkoknoi, Bangkok, 10700, Thailand

    Choakchai Metheetrairut, Chanticha Chotikavanich & Phawin Keskool

  2. Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Nit Suphaphongs

Authors
  1. Choakchai Metheetrairut
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chanticha Chotikavanich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Phawin Keskool
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nit Suphaphongs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Choakchai Metheetrairut.

Ethics declarations

Conflicts of interest

The authors declare no conflicts of interest. Some data of this study was presented in the 13th Asia-Oceania ORL-HNS Congress in Taiwan on March 20th, 2015.

Research involving human participants and/or animal

This study is a retrospective study for which formal consent is not required. This study was approved by the institutional review board.

Informed consent

Not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Metheetrairut, C., Chotikavanich, C., Keskool, P. et al. Carotid body tumor: a 25-year experience. Eur Arch Otorhinolaryngol 273, 2171–2179 (2016). https://doi.org/10.1007/s00405-015-3737-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-015-3737-z

Keywords

Search

Navigation