1/11. Bilateral carotid body paraganglioma: case report.CONTEXT: 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. CASE REPORT: A 63-year-old patient was submitted to resection of two carotid body paraganglioma tumors found in the right-side and left-side carotid bodies at the bifurcation of the common carotid arteries. Two surgeries were performed at different times and neither of them presented any morbidity. Arteriography was fundamental for diagnosis of the small, asymptomatic tumor on the right side. DESIGN: Case Report- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/11. Carotid body tumors: the role of preoperative embolization.Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment with large asymptomatic carotid body tumors-one 4 cm and one 5 cm in diameter. Both patients had preoperative angiography the day before surgery that revealed the feeding arterial vessels so that successful embolization could be accomplished with gel. Success was judged by diminution of the angiographic blush. Both patients had an uneventful surgical excision the following day with the carotid body tumors being able to be resected periadventitially without damage to either the external or internal carotid artery. The cranial nerves were preserved in both patients and blood loss was only 200 cc in both cases. We conclude that preoperative embolization is an important adjunct in treating patients with large carotid body tumors. The surgical exploration proceeds much smoother, the blood loss is minimal, and patients have minimal morbidity.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/11. Aortico-pulmonary paraganglioma associated with bilateral carotid body tumors. Diagnostic presentation and clinical implications.A case of mediastinal paraganglioma in association with bilateral carotid body tumors is presented. Characteristic radiological findings included a hypointense signal in T1-weighted, a hyperintense signal in T2-weighted magnetic resonance (MR) images and a vascular enhancement pattern in dynamic contrast enhanced MR imaging. Thus, feeding vessels could be depicted noninvasively. The importance of family screening in affected individuals is stressed, as a hereditary form of the disease exists in which multiple paragangliomas are common.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/11. Carotid body tumour.A case of carotid body tumour (paraganglioma) which is both unusual and highly vascular, arising from the carotid body is reported. The patient was a 68-year-old female with a right submandibular swelling. The initial pathological diagnosis was obtained from the incisional biopsy. Carotid angiography revealed the feeding vessels arising only from the external carotid artery. The tumour was completely removed and no evidence of recurrence could be found 2-years postoperatively.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/11. Temporary balloon occlusion and ethanol injection for preoperative embolization of carotid-body tumor.We report on the preoperative embolization of a carotid-body paraganglioma by temporary balloon occlusion and ethanol injection. Complete devascularization was achieved without complication. Resection after a short postembolization interval required artery sacrifice. Histologic evaluation revealed that the tumor contained diffuse ethanol-induced microemboli. Compared with unembolized and polyvinyl-alcohol-embolized carotid-body paragangliomas, our technique resulted in no greater adverse effects on the tumor-vessel interface. This procedure is an effective and promising method of preoperative embolization of carotid-body tumors and warrants further experience and study. In this article, we also review the literature on carotid-body tumor embolization and ethanol embolization.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/11. Angiographic features of lateral cervical masses.An audible bruit may represent a clue to the vascular nature of the lesion. angiography is definitely indicated in the presence of pulsatile cervical masses with or without an associated bruit, and should be more widely utilized in the future for evaluation of cervical masses. In addition to the nature of the mass, angiography may also be of value in outlining the extent of the mass and its relationship to major vessels. Magnification and subtraction angiographic techniques with their improved detail may play an important role in clarifying the etiology of cervical masses, and hence facilitate the plan of therapy. If reasonable uncertainty as to the clinical diagnosis exists, angiography should be considered a diagnostic aid.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/11. Doppler color flow imaging of carotid body tumors.Doppler color flow imaging is a new ultrasound method for the simultaneous spatial display of tissue and vessel morphology (B-mode echotomograms) and of color-coded blood flow velocity information (Doppler-mode analysis). This new method is particularly useful in the neck, not only for the assessment of brain arteries but also for the safe and valid identification of carotid paragangliomas compared with other neck tumors. Early clinical detection of carotid paragangliomas is difficult since these lesions often occur sporadically and the patients remain symptom-free until the tumor becomes noticeable. Doppler color flow imaging allows the diagnosis of even small paragangliomas, which may improve management because of existing complications of surgical therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/11. carotid body tumor: atypical angiogram of a functional tumor.Carotid body tumors (CBTs) are rare, usually benign, neoplasms of the extra-adrenal paraganglion system. They are almost always nonfunctional. The diagnosis is generally confirmed by an angiogram that shows a vascular tumor enlarging the space between the internal and external carotid arteries. A 55-year-old man with hypertension and episodes of flushing, palpitations, and dizziness was treated for a firm, nonmobile mass measuring 3 x 2 cm at the left carotid bifurcation. plasma and urine catecholamines, and the vanilylmandelic acid/creatinine ratios were elevated. Carotid arteriograms showed a vascular mass displacing the vessels, but the space between the arteries was narrowed rather than enlarged, and an atherosclerotic plaque was present. At operation the CBT was removed by resection of the bifurcation and with a temporary shunt a saphenous vein graft was inserted between the common and internal carotid arteries. Pathologic examination revealed a typical paraganglionoma. Although most CBTs produce catecholamines, only 11 patients have been reported to have elevated plasma and urine levels, and most were symptomatic. Since these tumors slowly increase in size, early surgical removal is recommended, even in asymptomatic patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/11. Bilateral carotid body tumors managed with preoperative embolization: a case report and review.A patient with large bilateral carotid body tumors had preoperative, superselective embolization of major arterial afferent vessels. After marked reduction in tumor vascularity, total surgical extirpation was then possible without significant morbidity or carotid sacrifice. The use of preoperative embolization in the treatment of large bilateral lesions is emphasized and discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/11. Preoperative embolization for paraganglioma.We have applied a new method of preoperative embolization to an intravagal and to carotid body paraganglioma, using estrogen dissolved in absolute alcohol and polyvinyl alcohol particles, which diffusely embolizes vessels from capillaries to main feeders. Total resection of the tumors after embolization was successively performed without postoperative complications; total blood loss was 205 and 130 ml, respectively, and the surgical time was approximately 3 hours in both cases. The technique, characteristics, and advantages of this method are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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