Carotid body tumors: Surgical experience in 215 cases.

INTRODUCTION: Carotid body tumors (CBT) are very unusual neck lesions. However, at high altitudes, they are less rarely found. This study intended to review our experience in diagnosis and surgical treatment of these lesions. MATERIALS AND METHODS: Among 242 clinically diagnosed CBT, 215 tumors, arising in and retrospectively studied. All patients came from the Andean plateaux. Mean age was 52.5 years, 180 were females, and mean size was 4.21 cm. Shamblin type distribution, described in 187 patients, was: Type I 29(15%), type II 118(63%) and type III 40(22%). A correct preoperative diagnosis of CBT was made in 95% of the patients, based on clinical grounds and imaging studies. Complete CBT resection was performed in 209 tumors (97%). Twenty-three (11%) accidental preoperative vessel injuries were successfully repaired. Preoperative blood transfusion was used in only 16 cases. RESULTS: There was no operative mortality. Postoperative complications occurred in 59(27.5%) procedures, mostly minor and related to cranial nerve dysfunction. No stroke occurred in any patient. Seven (3%) cases were malignant. CONCLUSION: A systematic surgical technique allowed us to perform a complete CBT resection in most patients, unusual operative vascular accidents, low morbidity and no mortality.

Preoperative imaging diagnosis of carotid body tumors.

Carotid body tumors (CBTs) are relatively frequent lesions encountered at high altitudes, such in as the Andean Mountains. A correct preoperative diagnosis is essential for surgical planning and performance. For this reason, we have reviewed the evolution of our experience in the imaging diagnosis of these tumors. Between 1980 and June 2008, 160 CBTs were diagnosed. A total of 138 tumors were operated on, 4 are waiting for surgery, and 18 were not operated on because of age, medical conditions, or patient refusal. We have reviewed retrospectively the modalities of imaging diagnosis in our patients who underwent operation. Among the 138 tumors operated on, a correct preoperative diagnosis was done in 127 cases (92%). The preoperative diagnosis of the remaining 11 patients was unspecified benign tumor for 6 patients and neck lymph node for 5 patients. The imaging methods performed by different radiologists were conventional ultrasound, color Doppler ultrasound, carotid conventional angiography (CA), axial tomography, magnetic resonance and magnetic resonance angiography, and computed tomographic angiography (CTA). Most patients had more than one image study. Review of radiologist reports revealed a correct diagnosis in all carotid CA, magnetic resonance studies, and CTA. Additionally, CTA appeared to be a valuable method to predict the Shamblin group. Clinical suspicion and current image techniques permit a correct diagnosis in practically all cases of CBT.