Vascular: Carotid Body Tumor

Basics

• Also Known As:
  • Carotid Paraganglioma
  • Carotid Chemodectoma
  • Glomus Tumor
• Most are Benign & Slow Growing But May Be Locally Aggressive
• Most are Nonfunctional – But Can Potentially Secrete Catecholamines
• Highly Vascular

Forms

• Spontaneous – Most Common
• Familial – More Frequently Bilateral or Present Earlier
• Hyperplastic – More Common if Exposed to Prolonged Hypoxia (COPD or Living at High Altitudes)

Shamblin Classification

• Group I: Small & Easily Dissected Off the Carotid Artery Walls
• Group II: Larger, Partially Surround & More Adherent to the Carotid Artery Adventitia
• Group III: Encase the Carotid Arteries with Intimate Adherence

Presentation

• Asymptomatic Neck Mass – Most Common
• “Fontaine Sign” (Laterally Mobile but Fixed Longitudinally – From Association with Artery)
• Pain
• Compressive Symptoms (Dysphagia, Hoarseness or Horner’s Syndrome)

Diagnosis

• Dx: US or CTA/MRA
  • “Lyre Sign” Pathognomonic (Widened Bifurcation & Tumor Blush Between)
• Do Not Bx – Due to Bleeding Risk

Treatment

• Primary Tx: Surgical Resection
  • Keep to Periadventitial Plane if Able – Extension of Adventitia May Weaken Artery & Cause Hemorrhage
• Consider Preoperative Angioembolization Prior if Large (> 4 cm)