Carotid Paraganglioma - Classical Surgical Technique.

INTRODUCTION

A carotid body tumor is a rare neoplasm, generally benign, that predominantly affects people between their fourth and fith decades of life. It manifests as a pulsatile and generally painless cervical mass with firm consistency, located below the angle of the jaw. Clinically it can cause localized pain, dysphagia, hiccups, hoarseness and hypersensitive carotid body syndrome. Surgery is the treatment of choice, bearing in mind the possibility of malignant transformation, peritumoral invasion and metastasis. The most widely-used technique is surgical resection, with or without concomitant preoperative endovascular embolisation. Overall complication rates, stroke rates between 0 and 8% and cranial nerve palsy less than 1% to 49%. Mortality rates vary from 0 to 3%.

METHODS

Clinical case of a 69 years old male patient diagnosed with a carotid body tumor in a routine ultrasound exam. The patient was asyntomatic. Complementary exams were then conducted - CT scan and MRI supported the diagnosis. Neck CT scan: Well defined, nodular formation, enhanced after intravenous contrast, localized on the jugular-carotid region, with an aproximate diameter of 36 mm. Neck MRI: Expansive heterogenous solid lesion, localized on carotid bulb, well defined, enhanced after intravenous contrast, compatible with carotid paraganglioma - Shamblin's II.

RESULTS

Patient was submited to a complete surgical classic ressection of the tumor, without any previously procedure. Proximal dissection was made with a help of a nose and ear surgeon. No post-surgery complications, except wound infection at week 3. No nerve damage.

CONCLUSION

Follow up to 1 year without any complain and no lesions. In an era of multiple techniques there should always be a place for classic, well planned surgeries.