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Carotid Body Paraganglioma

Carotid Body Tumor


Presentation

  • BACKGROUND: The present study reviewed a 30-year experience of managing carotid body paraganglioma (CBP) and analysed clinical findings associated with perioperative morbidity.[ncbi.nlm.nih.gov]
  • The first case was a 36-year-old gentleman who presented with 6 months history of painless swelling on the left side of neck.[ncbi.nlm.nih.gov]
  • A 62-year-old woman with a bilateral carotid body paraganglioma presented, 2 years after the removal of the right one, with signs of right-heart failure.[ncbi.nlm.nih.gov]
  • The patient initially presented with a neck mass and palpitations. Laboratory test results showed elevated catecholamine levels.[ncbi.nlm.nih.gov]
  • The second known case of a malignant catecholamine-secreting (DA)-secreting carotid body paraganglioma is presented. Dopamine synthesis and secretion can be increased in malignant tumors derived from neural crest cells.[ncbi.nlm.nih.gov]
Hypoventilation
  • PATIENTS AND METHODS: We report the case of a patient with obesity hypoventilation syndrome (OHS) in whom OSAS caused by a carotid body paraganglioma contributed to recurrent bouts of severe alveolar hypoventilation.[ncbi.nlm.nih.gov]
  • Central alveolar hypoventilation was diagnosed on the basis of absence of ventilatory response and sensation to provoked hypercapnia, prolonged breath-holding time and correction of hypercapnia by voluntary hyperventilation.[ncbi.nlm.nih.gov]
Tinnitus
  • Cranial nerve palsies can occur and include dysphagia, hoarseness, and tinnitus. Rarely, a carotid body tumor may contain neurosecretory granules, which cause symptoms such as palpitations, headaches, diaphoresis, dizziness, and flushing.[evtoday.com]
  • It is pathognomonic for this tumour but it usually follows a year after the initial symptoms of hearing loss and pulsatile tinnitus.[patient.info]
  • When significant involvement is present then the lesion may cause pulsatile tinnitus and hearing loss. Additionally, a number of patterns of cranial nerve palsies have been described due to the involvement of the nerves at the jugular foramen.[radiopaedia.org]
  • This symptom is called pulsatile tinnitus. Most patients with glomus tumors of the middle ear can hear a pulsing sound in the ear on the side which has the tumor.[earsurgery.org]
Neck Swelling
  • A middle-aged male patient presenting with a neck swelling was diagnosed with a glomus vagale tumor on USG by the direct demonstration of its continuity with the vagus nerve, and Doppler examination confirmed its vascularity.[ncbi.nlm.nih.gov]

Workup

  • This case report describes two patients with this rare tumour with diagnostic workup and treatment options. The first case was a 36-year-old gentleman who presented with 6 months history of painless swelling on the left side of neck.[ncbi.nlm.nih.gov]
  • Objective: Here we present the case of a fatal norepinephrine secreting carotid body paraganglioma diagnosed incidentally during workup for a suspected stroke.[omicsonline.org]

Treatment

  • We describe the case and analyse the treatment options of CBP.[ncbi.nlm.nih.gov]
  • Surgical treatment of carotid body paragangliomas is a challenge to the surgeon because of the large vascularization of the tumor, involvement of the carotid vessels and the close anatomical relationship with the cranial nerves.[ncbi.nlm.nih.gov]
  • Treatment including external radiation and surgery provided pain relief and early local disease control.[ncbi.nlm.nih.gov]
  • This case report describes two patients with this rare tumour with diagnostic workup and treatment options. The first case was a 36-year-old gentleman who presented with 6 months history of painless swelling on the left side of neck.[ncbi.nlm.nih.gov]
  • The diagnosis and treatment of baroreflex failure. N Engl J Med. 1993; 329(20): 1449-55. Gil-Carcedo E, Gil-Carcedo LM, Vallejo LA, Herrero D, Ortega C. Diagnosis and treatment of carotid body paragangliomas.[revista.acorl.org]

Prognosis

  • Treatment and prognosis Surgical excision is the treatment of choice. The larger the tumor the higher the risk of operative complications 2 . In patients for whom the risk of complications precludes surgery, radiotherapy may be considered 1-2 .[radiopaedia.org]
  • Updated and new perspectives on diagnosis, prognosis, and therapy of malignant pheochromocytoma/paraganglioma. [Internet] J Oncol. 2012 [Consultado 2014 11Ene]; 2012: 872713.[revista.acorl.org]
  • Treatment and prognosis Surgery is the treatment of choice and if complete resection is achieved a cure can be expected.[radiopaedia.org]
  • Prognosis Glomus jugulare tumours tend to grow slowly with only a small proportion metastasising. The associated cranial nerve palsies tend to be more cosmetic than debilitating.[patient.info]
  • The location, presenting symptoms, patient characteristics, demographics as well as prognosis and outcome vary depending on tumor type, and it is important to clearly delineate the type of tumor for which the embolization procedure is being reported.[jnis.bmj.com]

Etiology

  • They have a low incidence (0.6%), are generally benign, have a poorly defined etiology, and multiple factors have been associated with their origin.[ncbi.nlm.nih.gov]
  • 01 Aim: The aim of this study is to assess the sensitivity and specificity of procalcitonin to determine bacterial etiology of diarrhea.[science.gov]

Epidemiology

  • Each entity is extensively discussed with information on clinicopathological, epidemiological, immunophenotypic and genetic aspects of these diseases. The book is an authoritative, concise reference, prepared by 150 authors from 20 countries.[books.google.com]
  • Parry DM, Li FP, Strong LC et al. (1982) Carotid body tumors in humans: genetics and epidemiology. J Natl Cancer Inst 68/4: 573–578 Google Scholar 23.[link.springer.com]
  • […] body paraganglioma Jugulotympanic paraganglioma (previously called glomus jugulare tumors) Vagal paraganglioma Laryngeal paraganglioma Chemodectoma refers to carotid and aortic body paraganglioma (tumors of paraganglia with a chemoreceptor function) Epidemiology[pathologyoutlines.com]
  • Epidemiology [ 1 ] The annual incidence is about 1 in 1.3 million people per year. However, it is the most common tumour of the middle ear and the second most common tumour of the temporal bone.[patient.info]
Sex distribution
Age distribution

Prevention

  • Malignant catecholamine-secreting carotid body paragangliomas are best treated by composite resection (internal carotid artery and neck dissection), with special attention being given to measures preventing severe hypertension and arrhythmias in the perioperative[ncbi.nlm.nih.gov]
  • Timely diagnosis and treatment may have prevented this fatality. Biography : Email: [email protected][omicsonline.org]
  • Postoperatively, intensive surveillance with intermittent nasogastric suctioning was done to prevent aspiration or obstruction of airway due to IX, X, and XII cranial nerve dysfunction.[karnatakaanaesthj.org]
  • In most cases, it is necessary to tie off or pack the jugular vein in the neck and the mastoid portion of the ear to prevent excessive bleeding at tumor removal.[earsurgery.org]

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