[Our experience with the surgical treatment of paraganglioma of the glomus caroticum].

INTRODUCTION

The glomus caroticum, located at the carotid bifurcation, contains chemoreceptors and is essential for the rapid physiological adaptation to changes in blood oxygen, carbon dioxide, and pH levels. Paragangliomas of the glomus caroticum are rare, slow-growing, hypervascularized neuroendocrine tumors of parasympathetic origin, typically located on the neck and potentially infiltrating adjacent structures.

OBJECTIVE

To analyze and summarize surgical outcomes of glomus caroticum paragangliomas treated at our institution between 2015 and 2024.

METHOD: In our retrospective analysis, patient demographics, surgery duration, hospitalization time, complications, histological diagnoses, and follow-up data were analyzed.

RESULTS

A total of 17 patients (7 males, 10 females) underwent 19 surgeries. Mean age was 56.41 years (median: 58). Mean operative time was 104 minutes; mean hospitalization was 5.84 days (median: 6). Preoperative embolization was performed in 9 cases, with a longer average surgical time (117 minutes) compared to non-embolized cases (94 minutes). Histology confirmed paraganglioma in 16 cases, Antoni type A schwannoma in 1, metastatic breast ductal carcinoma in 1, and colloid calcified struma nodosa in 1 case. Carotid revascularization was required in 2 cases using Dacron and polytetrafluoroethene grafts, respectively. Neurological complications occurred in 9 cases, including hoarseness and difficulties with speech or swallowing. 1 patient with polytetrafluoroethene graft experienced visual field loss and ptosis.

DISCUSSION: Contrary to prior findings, preoperative embolization did not reduce operative time in our cohort. However, due to the limited sample size, further studies are necessary.

CONCLUSION

In order to promote the essential multidisciplinary approach in patient care, we advocate the establishment of an endocrine/paraganglioma team in centers with a high level of progressivity. Orv Hetil. 2025; 166(51): 2012-2017.