Carotid body Tumour with Hypoglossal Nerve Palsy- A Case Report (original) (raw)

Carotid body tumor: a case report and literature review

Journal of Radiology Case Reports, 2019

The carotid body is the largest collection of paraganglia in the head and neck and is found on the medial aspect of the carotid bifurcation bilaterally. Carotid body tumors are rare neoplasms arising from the chemoreceptor cells of the carotid bulb. We report a case of carotid body tumor in a 42year-old female, who presented with painless, pulsatile, gradually progressive lateral neck swelling. The diagnosis is suspected on the basis of history, clinical and radiological examination findings and a successful surgical excision of the tumor is performed. Histopathological examination confirms the diagnosis of carotid body tumor. We also present brief literature about carotid body tumors in terms of its clinical and imaging presentation, evaluation, and management. CASE REPORT Carotid body tumors (CBTs), also known as paragangliomas or chemodectomas, are rare neuroendocrine neoplasms which arise near the carotid bifurcation within glomus cells derived from the embryonic neural crest. The reported incidence of CBTs is 1-2 per 100,000 [1]. CBTs are rare chemical receptor tumors which accounts for 0.6% of the head and neck tumors in humans. The CBT is usually benign with the incidence of malignant tumors below 10% [2]. The majority of these tumors are asymptomatic and initially noticed by inspection and palpation of neck swelling during the physical examination, or more commonly as incidental findings on radiological imaging studies. Nonetheless, the most observed symptoms are a pain, dysphagia, and autonomic dysfunction in symptomatic cases [3], [4]. Clinical presentation of the tumor is an asymptomatic slow growing mass in neck. However, they can produce symptoms due to pressure and local invasion of the surrounding tissue. Most commonly involved are hypoglossal nerve, glossopharyngeal nerve, vagus nerve and sympathetic chain [5]. Clinical history, examination, and radiological diagnosis are the keystones to diagnosis and management. Ultrasound, Computed tomography (CT) and Magnetic resonance imaging (MRI) are useful radiological tools in diagnosis. Yet Angiography is essential to study about the vascular anatomy [6]. Thus, in order to prevent local invasion and metastasis, early surgical excision is considered a primer curative treatment option for the treatment of CBTs. In this paper, we report a case of CBT which was successfully treated with complete surgical excision and review the literature.

Diagnosis and management of carotid body tumor: a report of seven cases

Turkish Journal of Thoracic and Cardiovascular Surgery, 2013

Paragangliomalar embriyolojik nöral crestden gelişen otonom sinir sisteminin paraganglionik gövdelerinden ortaya çıkan ve yavaş büyüyen, nadir görülen, çoğunlukla asemptomatik ağrısız tümörlerdir. Yavaş büyüyen tümörler olmasına rağmen malignite ve lokal agresif büyüme potansiyelleri, komşu vasküler ve nöral dokulara invazyon veya bası yapmaları nedeniyle karotis cisim tümörlerinin erken tanı ve cerrahi tedavilerinin planlanması önemlidir. Bu yazıda boyun bölgesinde ağrı ve şişlik yakınması ile başvuran, klinik muayene ve ileri incelemeler sonucu karotis cisim tümörü tanısı konulan ve cerrahi tedavi uygulanan yedi olgu, literatür bilgileri eşliğinde sunuldu ve uygulanan farklı cerrahi yöntemler tartışıldı. Anah tar söz cük ler: Karotis cisim tümörü; tanı; cerrahi; tedavi. Paragangliomas are rare asymptomatic painless tumors, originating from paraganglionic bodies of autonomous nerve system of the embriological neural crest and increasing gradually. Despite their gradual developing nature, it is critical to reach early diagnosis and tailor surgical plan for carotid body tumors due to their potential of being malignant and local aggressive development, as well as invasion or pressure on the adjacent vascular and neural tissues. In this article, we present seven cases who were admitted with the complaints of pain and swelling in the neck and were diagnosed with carotid body tumor based on the further investigations and were surgically treated in the light of literature review and different surgical modalities were discussed.

“Carotid body tumour: A case report”

IOSR Journal of Pharmacy and Biological Sciences, 2014

Carotid body tumours are rare, slowly growing benign neoplasm arising from paraganglionic cells at the region of carotid bifurcation. They are the rare tumours of head and neck region derived from neural crest. We report here a case of carotid body tumour which was successfully treated surgically.

Carotid body tumors: a case series and review of the literature

Annals of vascular surgery, 2017

Paragangliomas of the head and neck are rare vascular tumors derived from the paraganglia tissues originating from the neural crest. They are usually benign and hyper-vascularized. Diagnosis is relatively easy in condition to consider it in evaluating every lateral neck mass. We made a retrospective study of the records of ten patients who presented with carotid body tumors at the Vascular surgery department of the Military Hospital Avicenne in Marrakech during the period between 2008 and 2013. Epidemiologic, etiologic, diagnostic and therapeutic features were analyzed. The average age of our patients was 35,4 years (26 to 55 years), with a male predominance (sex-ratio: 2,33). We noted seven cases of isolated carotid locations and three cases of multiple locations. A slow growing neck mass was the main clinical presentation. Other signs were pain, dysphonia, dizziness, headache and tinnitus. Physical examination showed, in most cases, a neck nontender mass with side to side mobility...

Carotid body tumors: challenging complexity of diagnosis and surgical treatment

Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, 2003

Objectives: To evaluate the patients treated for carotid body tumors and the problems encountered during diagnosis and treatment. P a t i ents and Methods: The study included eight patients (5 females, 3 males; mean age 50 years; range 36 to 68 years) who underwent surgery for carotid body tumors. Diagnosis was confirmed by power Doppler ultrasonography and computed tomography or magnetic resonance imaging in all patients. Angiography was performed in three patients to evaluate vascularity and to perform embolization before surgery. Two patients had previously undergone biopsy elsewhere. The mean follow-up was 15 months (range 2 to 36 months). Res u l t s : The size of the tumors varied from 3 cm to 11 cm. In two patients the tumors were found to extend to the skull base. Ligation of the external carotid artery and the common carotid artery was performed in five patients and in one patient, respectively. Surgery-associated injuries given to the internal carotid artery in two patients were repaired by sutures. The 10th cranial nerve was dissected in two patients who had undergone a prior biopsy. They developed cord paralysis and hoarseness postoperatively. Resection of the 11th cranial nerve in one patient resulted in shoulder pain and drop shoulder. The 12th cranial nerve was repaired end-toend by neurorrhaphy in two patients. They exhibited significant improvement in nerve functions a year after surgery. Conclusion: The larger the tumor is, the more difficult the resection is, and the more injuries are caused to the surrounding nerves and vessels.

Bilateral sporadic carotid body tumors—A rare case report

Carotid body tumor presents as palpable mass in anterolateral aspect of the neck. However, bilateral sporadic carotid body tumor is a rare anomaly, reported to occur in 5% of population. We are going to report the case of a 60-year-old patient who presented to our department with painless, palpable mass bilaterally in anterolateral aspects of the neck. He did not have any family history of neck masses. This paper summarizes the topic of carotid body tumor and discusses the radiological and clinical implications of this condition.

A large carotid body tumour: a rare case report

International Surgery Journal, 2017

Carotid body tumour (CBT) is one of the most common jugular paraganglioma involving the carotid body chemoreceptors. We report the case of a 22 year young man who presented with complain of large painless progressive swelling in right upper neck for 3 years duration. On examination, swelling appeared pulsatile and arising from carotid vessel. MRI Neck and MRA performed revealed large well defined hypervascular mass lesion encasing right common carotid artery, its bifurcation and ECA, with feeders from ECA. Patient was undertaken for surgical excision (Shamblin Grade-III) through exposure in neck, extended by midline sternotomy and mandibulotomy approach, tumour was completely dissected. Patient recovered well from surgery without any sequale. HPE revealed CB paraganglioma. At two years follow up, he is recurrence free. The surgical removal of CBT has a good result.

Carotid body tumour - an experience of 8 years at SSKM Hospital, IPGME& R, Kolkata, India

Indian Journal of Thoracic and Cardiovascular Surgery, 2012

Objective To review our experience of management of carotid body tumours at SSKM hospital, IPGME&R, Kolkata, India. Material and methods Seven patients who were operated between years 2003 and 2011 form the basis for this study. Their data was analyzed retrospectively from the hospital records. Diagnosis was made on history, physical examination and investigations such as Colour Doppler, Computed Tomography (CT) Angiography and Magnetic Resonance Imaging (MRI) scan of brain Results The most common age for presentation was third to fifth decade. Four patients were male and 3 female. Right side was commonly involved (five of seven). Most common presentation was a painless swelling. Five patients were in Shamblin grade II and two patients in grade III. In two patients external carotid artery was ligated and one patient had injury to internal carotid artery during surgery necessitating repair. In all of the cases internal carotid artery was preserved. No patient suffered cerebral stroke and all were discharged in good general condition. Conclusion Carotid body tumour is an uncommontumour. It commonly presents as a slow growing mass, usually on right side of the neck and surgery is the treatment of choice. Meticulous subadventitial dissection and excision is a good technique with low morbidity and mortality. The diagnosis of the tumours at an early stage reduces the risks and complications, associated with increased Shamblin grading of the tumour and allows good post operative results.

Carotid body tumour-- A rare case report

IOSR Journal of Dental and Medical Sciences, 2012

Carotid Body Tumour (CBT) is a uncommon tumour which arises from a chemoreceptor tissue, which is present at the bifurcation of common carotid arteries. Not many case reports have been reported for carotid body tumours. We report an unusual case of a large carotid paraganglioma in a 31-year-old female. This neck swelling was present, for several years before admission, but was smaller in size.