Definition
A carotid body tumor is also known as paraganglioma or chemodectoma which is a tumor situated in the upper neck where the carotid artery also branches into blood vessels to transport blood into the brain.
Tumors that develop on the carotid glomus is not life-threatening although they could rapidly grow and press on blood vessels and nerves close by, resulting to a damage to those structures.
Few individuals even develop multiply tumors that are smaller rather than a single tumor. Paragangliomas could develop anywhere along any major arteries in the body such as the neck, abdomen, skull region, bladder, chest cavity, and pelvis. These tumors are rare and can occur in both males and females which are commonly seen in those middle aged individuals or older.
Symptoms of Carotid Body Tumor
Symptoms of a carotid body tumor may not be present at first but it can typically be sensed as a painless mass on the side of the neck that grows slowly. As the tumor gets bigger over the years, symptoms will begin to occur and these include:
- Changes in vision
- Falling eyelid
- Harshness of voice
- Anxiety
- Sweaty skin
- Numbness in the tongue
- Rapid beating of the heart
- High blood pressure
- An abnormal sound of blood heard through a stethoscope
- Difficulty swallowing
- Pain or weakness in the shoulders
- Headaches
These tumors could sometimes be discovered unintentionally during an MRI or CT scans done for other purposes. When symptoms occur, they are commonly due to the increased production of norepinephrine or noradrenaline by the tumor. Tumors in the bladder might result to hypertension symptoms and spells with intercourse or urination. Approximately 50% will lead to hematuria or the blood in the urine.
Causes
In most cases of individuals with a carotid body tumor, the cause is not known with the exemption of hypoxia which is the oxygen deficiency in a certain area of the body. There is a smaller percentage that there’s a genetic connection.
Diagnosis
Once a carotid body tumor is suspected by the physician on a physical examination, a Doppler ultrasound may be done to see if there is a tumor that can be detected.
Doppler ultrasound
It is a noninvasive test that could estimate the blood flow through a blood vessel by the use of reflected sound waves to the red blood cells. A regular ultrasound cannot show blood flow.
Other diagnostic tests that may be performed include:
Computerized tomography (CT) scans
It is an imaging test that may be used to validate the existence of a tumor.
Magnetic resonance imaging (MRI) scans
An imaging test that could produce detailed images of organs and structures of the body, including the blood vessels and the tumor itself. This test is excellent for diagnosing the tumor.
Magnetic resonance angiogram (MRA) scans
It is a combination of MRI and an angiogram. This test is the best tool for diagnosing the tumor since it makes use of pulses and a magnetic field to produce detailed pictures of the tumor and the blood vessels. The test is helpful to the neurosurgeon and radiologist for the examination of the tumor and blood vessels. MRAs and CT angiograms can make excellent diagnostic images of a carotid body tumor.
Treatment
The physician will recommend the treatment option that suits best for each patient. Before deciding on any treatment, it is essential to discuss everything with the physician such as the side effects, potential benefits, and risks. Treatment for carotid body tumors is very safe in general and outcomes are also great. The best option is a surgical treatment.
Transcatheter Embolization is sometimes performed two or three days before surgery wherein the physician injects a certain medication to the area of the paraganglioma in order to reduce or stop the supply of blood to the tumor.
Surgery/surgical procedure of a carotid body tumor involve the removal of the tumor and the repairing of any damage of the carotid artery. The surgery is done in a very delicate space near the critical carotid artery that produces blood to the brain and other nerves.
Surgical resection of the carotid body tumor happens after the embolization. The neurosurgeon will make an incision in the patient’s neck and executes an open surgical procedure to take out the tumor.
Temporary shunt may be needed by the patient in order to carry blood into and out of the carotid artery throughout the surgery. The repairing of the carotid artery after surgery is varied on the tumor’s location and size. Occasionally, stitching of the carotid artery is enough but in some other cases, resection of the tumor builds a hole in the carotid artery which has to be repaired.
Bypass grafting may be done to enhance blood flow to the heart if the damaged region requires a complete removal.
References
- Diagnosing and Treating & Surgery for a Carotid Body Tumor at http://weillcornellbrainandspine.org/condition/carotid-body-tumors
- http://my.clevelandclinic.org/services/heart/disorders/hic_Carotid_Artery_Disease/carotid_body_tumors
- http://endocrinediseases.org/adrenal/paraganglioma.shtml
- Zhang TH, Jiang WL, Li YL, et al. Perioperative approach in the surgical management of carotid body tumors. Ann Vasc Surg. 2012 Aug. 26(6):775-82.
- Janda PH, Veerappan V, McKenzie ME, Dhudshia NV. Carotid body tumor as a reversible cause of syncope. J Am Osteopath Assoc. 2011 Nov. 111(11):638-44.
- Sahin MA, Jahollari A, Guler A, Doganci S, Bingol H, Karaman B, et al. Results of combined preoperative direct percutaneous embolization and surgical excision in treatment of carotid body tumors. Vasa. 2011 Nov. 40(6):461-6.
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