Presentation
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]
In 2004, Galvão et al(2) presented a case of bilateral paraganglion in the carotid body which, at the physical exam, presented a bilateral cervical mass which was hard, elastic, painless, pulsatile, vertically unmovable, horizontally movable, taking the [arquivosdeorl.org.br]
Tumor presented a wide variety of size and clinical presentations. [agris.fao.org]
Case Report A 22-year-old female presented with a swelling in the right lower cervical region for 5 months. [jdrntruhs.org]
Entire Body System
- Pain
You may be able to feel the tumor, but it is not painful. If the tumor becomes large, it can press on the nerves, blood vessels or organs around it. This may cause throat pain, hoarseness, a numb tongue or make it hard to swallow. [my.clevelandclinic.org]
Treatment including external radiation and surgery provided pain relief and early local disease control. [ncbi.nlm.nih.gov]
Pain was associated feature in nine (20.43%) of patients. Mean duration of pain being 4.222 ± 1.787 months with a minimum duration of 2 months and maximum of 8 months. Median duration being 4 months dysphagia was found in three (6.81%) patients. [indjvascsurg.org]
Summary A 48-year-old hypertensive and diabetic patient presented with a 10-year history of progressive right facial pain, tinnitus, hearing loss, sweating, and palpitations. [edmcasereports.com]
- Pallor
A small number of patients present primarily with a phaeochromocytoma-like picture - eg, perspiration, pallor, nausea, hypertension and tachycardia. [patient.info]
Personal medical history for the following: Symptoms of catecholamine excess that can include sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, palpitations (perceived episodic, forcible, often rapid heart beat), pallor [adrenaltumors.org]
Other related symptoms include headache, perspiration, pallor, and nausea. [3] Otoscopic examination reveals a characteristic, pulsatile, reddish-blue tumor behind the tympanic membrane that is often the beginning of more extensive findings (ie, the tip [emedicine.medscape.com]
- Weakness
The physical exploration was normal although the global situation of the patient was bad, with progressive weakness and difficulties in her daily life. [academic.oup.com]
The cranial nerves of the jugular foramen may be compressed, resulting swallowing difficulty, or ipsilateral weakness of the upper trapezius and sternocleiodomastoid muscles (from compression of the spinal accessory nerve ). [en.wikipedia.org]
- Hypoxemia
Hypoxemia, hypercapnia, polycythemia and pulmonary hypertension with normal ventilatory capacity were found. [ncbi.nlm.nih.gov]
[…] regulate breathing and blood pressure. 16 Glomus cells are also activated by hypoglycemia. 17 It is, however, the sensitivity to acute changes of O 2 tension that makes the carotid body fundamental for the adaptive hyperventilatory reflex in response to hypoxemia [ajnr.org]
- Epilepsy
We present a case of an 8-year-old girl with established focal epilepsy, whose fits resolved permanently after excision of a carotid body paraganglioma. [ncbi.nlm.nih.gov]
Respiratoric
- Pharyngitis
CLINICAL CASE: We present the case of a 16 year-old female with acute pharyngitis and growing tumor located on the left side of the neck, without symptoms. A duplex Doppler ultrasound showed a solid nodular lesion on the left carotid bifurcation. [ncbi.nlm.nih.gov]
The ascending pharyngeal artery is the main contributing supply. Scintigraphy Although not specific, shows uptake with metaiodobenzylguanidine ( MIBG ) and octreoscan scintigraphy and can be useful for assessing multiple lesions. [radiopaedia.org]
In our case, there was an involvement of a vagus nerve segment with the tumor, so we had to resect it in a segmental way, thus resulting on a partial affection of the pharyngeal and laryngeal motor functions. [arquivosdeorl.org.br]
Often the lingual or ascending pharyngeal arteries may be the dominant feeding vessels to a carotid body tumor. Deployment of microcoils is one method of embolizing carotid body tumors. [evtoday.com]
- Cough
Eight days before admission she had the onset of sore throat, nonproductive cough, and malaise. FULL TEXT [annals.org]
Associated symptoms may include unilateral hearing loss, pulsatile tinnitus, cough, hoarseness of voice, pharyngeal fullness, swallowing difficulty, pain, and/or problems with tongue motion. [adrenaltumors.org]
- Sore Throat
Eight days before admission she had the onset of sore throat, nonproductive cough, and malaise. FULL TEXT [annals.org]
Cardiovascular
- Hypertension
Hypertension persisted even after excision of both the tumours which could be controlled with anti-hypertensive agents. The case is discussed with review of literature. [ncbi.nlm.nih.gov]
Post operatively, she continued to require anti-hypertensives. [omicsonline.org]
This is a report of a rare cause of secondary diabetes and hypertension. Summary A 48-year-old hypertensive and diabetic patient presented with a 10-year history of progressive right facial pain, tinnitus, hearing loss, sweating, and palpitations. [edmcasereports.com]
- Tachycardia
A small number of patients present primarily with a phaeochromocytoma-like picture - eg, perspiration, pallor, nausea, hypertension and tachycardia. [patient.info]
[…] structure situated bilaterally within the adventitia at the bifurcation of common carotid artery, first described in 1743 by von Haller. [3] CBP arises from the glomus Type-1 cells of CB. [4] History of recently diagnosed or uncontrolled hypertension, tachycardia [karnatakaanaesthj.org]
The symptoms consisted of dysphagia, hoarseness, headache, high blood pressure and tachycardia crises. [arquivosdeorl.org.br]
In about 2-4% of cases, the first or leading symptoms are hypertension and tachycardia (pheochromocytomalike symptoms) produced by catecholamines, norepinephrine, or dopamine excreted by the tumor. [3] Also, somatostatin, vasoactive intestinal polypeptide [emedicine.medscape.com]
Musculoskeletal
- Neck Pain
Case Presentation Our case was a 39-year-old female who had been suffering from neck pain for 2 years. [ispub.com]
Five (11.35%) had a history of hypertension and (9.08%) had a history of neck swelling in the family. Pain was associated feature in nine (20.43%) of patients. [indjvascsurg.org]
Skin
- Sweating
She did admit to occasional headaches, episodes of sweating, tremors, and a throbbing sensation in the head. An increase in labetalol and nifedipine improved hypertension control and she was discharged with plan for surgery. [omicsonline.org]
Summary A 48-year-old hypertensive and diabetic patient presented with a 10-year history of progressive right facial pain, tinnitus, hearing loss, sweating, and palpitations. [edmcasereports.com]
[…] bilaterally within the adventitia at the bifurcation of common carotid artery, first described in 1743 by von Haller. [3] CBP arises from the glomus Type-1 cells of CB. [4] History of recently diagnosed or uncontrolled hypertension, tachycardia, excessive sweating [karnatakaanaesthj.org]
[…] knowledge of any relatives with unexplained or incompletely explained sudden death Personal medical history for the following: Symptoms of catecholamine excess that can include sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating [adrenaltumors.org]
Ears
- Tinnitus
It is pathognomonic for this tumour but it usually follows a year after the initial symptoms of hearing loss and pulsatile tinnitus. [patient.info]
Summary A 48-year-old hypertensive and diabetic patient presented with a 10-year history of progressive right facial pain, tinnitus, hearing loss, sweating, and palpitations. [edmcasereports.com]
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]
The presence of jugular foramen syndrome (paresis of cranial nerves IX-XI) is pathognomonic for this tumor, but it usually follows one year after the initial symptoms of hearing loss and pulsatile tinnitus. [emedicine.medscape.com]
Face, Head & Neck
- 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]
We describe detection of one such tumor by fine needle aspiration cytology in a 30-year-old lady with left neck swellings clinically suspected of tubercular lymphadenitis. [pacificejournals.com]
All patients n = 44 (100%) in our study presented with a complaint of neck swelling. Mean duration of swelling was 23.16 ± 16.34 with a minimum of 3 months to as long as 96 months. [indjvascsurg.org]
- Facial Pain
Summary A 48-year-old hypertensive and diabetic patient presented with a 10-year history of progressive right facial pain, tinnitus, hearing loss, sweating, and palpitations. [edmcasereports.com]
Neurologic
- Headache
She did admit to occasional headaches, episodes of sweating, tremors, and a throbbing sensation in the head. An increase in labetalol and nifedipine improved hypertension control and she was discharged with plan for surgery. [omicsonline.org]
Lateral carotid arteriogram obtained 22 years after radiation therapy in a 20-year-old woman who presented in June 1970 with episodic hypertension, headaches, and palpitations. [emedicine.medscape.com]
Headaches can occur as a result of intracranial extension. Signs The hearing loss may be conductive or sensorineural. [patient.info]
Rarely, a carotid body tumor may contain neurosecretory granules, which cause symptoms such as palpitations, headaches, diaphoresis, dizziness, and flushing. [evtoday.com]
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]
The patients were subjected to routine and specialized workup. [indjvascsurg.org]
Treatment
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 After careful explanation, the patient and her family consented to a therapeutic trial of octreotide. [edmcasereports.com]
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]
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]
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]
Overall prognosis is quite good with complete surgical resection. Continued follow-up is necessary, however, as recurrence and metastasis may occur years later. [adrenaltumors.org]
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]
If with most of the authors accepting the tumors' origin to be unknown(7), others believe that its etiology may be related to chronic hypoxia, high altitudes and dominant autosomic transmission with incomplete penetrance(6,7). [arquivosdeorl.org.br]
Interestingly, the male-to-female ratio differs in patients dwelling at high altitudes above 2,000 meters (1:8.3) than those patients dwelling at sea level (1:1.0-1.4). [14] Etiology The only known risk factors are the presence of chronic hypoxic stimulation [emedicine.medscape.com]
Exact etiology of these tumors is not known. Male and female distributions are equal except at high altitude where females appear to predominate. Diagnosis of a chemodectoma usually begins with a color flow duplex scan. [indjvascsurg.org]
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]
[…] 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]
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]
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]
Pathophysiology
Pathophysiology Carotid body tumors (CBTs) are classified into sporadic, familial, and hyperplastic forms. The familial paraganglioma form is a genetically heterogenous entity; currently, 4 genes are identified. [emedicine.medscape.com]
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]
Sternocleidomastoid muscle cover was provided to the carotid artery in all the patients to prevent secondary hemorrhage from the carotid artery. [icvts.oxfordjournals.org]