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03 October 2014 : Case report  Turkey

Five-Year Follow-Up of a Patient with Bilateral Carotid Body Tumors after Unilateral Surgical Resection

Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease

Tolga DemirAEG, Ibrahim UyarBCDF, Hale Bolgi DemirBEF, Mazlum SahinF, Gokcen GundogduBE

DOI: 10.12659/AJCR.891150

Am J Case Rep 2014; 15:426-430

Abstract

BACKGROUND: Carotid body tumors are rare, highly vascularized neoplasms that arise from the paraganglia located at the carotid bifurcation. Surgery is the only curative treatment. However, treatment of bilateral carotid body tumors represents a special challenge due to potential neurovascular complications.

CASE REPORT: We present the therapeutic management of a 34-year-old woman with bilateral carotid body tumors. The patient underwent surgical resection of the largest tumor. It was not possible to resect the tumor without sacrificing the ipsilateral vagal nerve. Due to unilateral vagal palsy, we decide to withhold all invasive therapy and to observe contralateral tumor growth with serial imaging studies. The patient is free of disease progression 5 years later.

CONCLUSIONS: Treatment of bilateral CBTs should focus on preservation of the quality of life rather than on cure of the disease. In patients with previous contralateral vagal palsies, the choice between surgery and watchful waiting is a balance between the natural potential morbidity and the predictable surgical morbidity. Therefore, to avoid bilateral cranial nerve deficits, these patients may be observed until tumor growth is determined, and, if needed, treated by radiation therapy.

Keywords: Angiography, Biopsy, Carotid Artery, Common - surgery, Carotid Body Tumor - surgery, Diagnostic Imaging - methods, Follow-Up Studies, Quality of Life, Time Factors, Vascular Surgical Procedures - methods

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923