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Successful treatment of a rare metastatic malignant carotid body tumour in a young adult, with conservative surgery and local radiotherapy

Published online by Cambridge University Press:  28 October 2011

J Williamson ,
G Leopold ,
V Prabhu  and
D Ingrams
J Williamson*
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
G Leopold
Affiliation:
Department of Histopathology, University Hospital of Wales, Cardiff, Wales, UK
V Prabhu
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
D Ingrams
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
*
Address for correspondence: Mr J Williamson, Department of ENT, Royal Gwent Hospital, Newport NP20 2UB, Wales, UK E-mail: jswilliamson@doctors.org.uk
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Abstract

Objective:

We report a patient with a malignant carotid body paraganglioma treated with surgery and adjuvant radiotherapy. We discuss her treatment and outcome in the light of the published literature.

Case report:

A 26-year-old woman presented with a 12-month history of a painless, left-sided neck lump. Ultrasound, computed tomography and magnetic resonance imaging revealed a carotid body tumour, which at surgical excision was found to be adherent to the vagus and hypoglossal cranial nerves (X and XII). The tumour was resected from the surrounding structures. Two local lymph nodes were removed to allow access. The internal carotid artery was also involved and had to be repaired with a synthetic graft. Histology and immunohistochemistry confirmed malignant carotid body paraganglioma. There were positive resection margins, and cervical lymph node metastasis was reported in one of the two nodes. Post-operatively, she had left Horner's syndrome, left vocal fold palsy and right upper limb weakness, all of which resolved spontaneously. She underwent adjuvant radiotherapy and remained recurrence free after 30 months.

Conclusion:

Malignant carotid body paraganglioma can affect young adults, with an insidious onset of symptoms. In this patient, local excision (without neck dissection) and adjuvant radiotherapy were well tolerated and resulted in satisfactory local disease control.

Keywords

Carotid Body TumourParagangliomaChemodectomaNeoplasm, MalignantSurgical Procedure, Operative
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 428 - 431
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Zbären, P, Lehmann, W. Frequency and sites of distant metastases in head and neck squamous cell carcinoma. An analysis of 101 cases at autopsy. Arch Otolaryngol Head Neck Surg 1987;113:762–4CrossRefGoogle ScholarPubMed
2Lee, JH, Barich, F, Karnell, LH, Robinson, RA, Zhen, WK, Gantz, BJ et al. National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer 2002;94:730–7CrossRefGoogle ScholarPubMed
3Pellitteri, PK, Rinaldo, A, Myssiorek, D, Gary Jackson, C, Bradley, PJ, Devaney, KO et al. Paragangliomas of the head and neck. Oral Oncol 2004;40:563–75CrossRefGoogle ScholarPubMed
4Zhang, WC, Cheng, JP, Li, Q, Zhang, L, Wang, XD, Anniko, M. Clinical and pathological analysis of malignant carotid body tumour: a report of nine cases. Acta Otolaryngol 2009;129:1320–5CrossRefGoogle ScholarPubMed
5Farr, HW. Carotid body tumors: a 40-year study. CA Cancer J Clin 1980;30:260–5CrossRefGoogle ScholarPubMed
6McPherson, GA, Halliday, AW, Mansfield, AO. Carotid body tumours and other cervical paragangliomas: diagnosis and management in 25 patients. Br J Surg 1989;76:33–6CrossRefGoogle ScholarPubMed
7Morton, RP, Stewart, T, Dray, MS, Farmilo, W. A role for ipsilateral, selective neck dissection in carotid body tumours. J Laryngol Otol 2009;123:934–6CrossRefGoogle ScholarPubMed
8Dias Da Silva, A, O'Donnell, S, Gillespie, D, Goff, J, Shriver, C, Rich, N. Malignant carotid body tumor: a case report. Vasc Surg 2000;32:821–3CrossRefGoogle ScholarPubMed
9Dinges, S, Budach, V, Stuschke, M, Schmidt, U, Budach, W, Sack, H. Malignant paragangliomas – the results of radiotherapy in 6 patients [in German]. Strahlenther Onkol 1993;169:114–20Google ScholarPubMed
10Mayer, R, Fruhwirth, J, Beham, A, Groell, R, Poschauko, J, Hackl, A. Radiotherapy as adjunct to surgery for malignant carotid body paragangliomas presenting with lymph node metastases. Strahlenther Onkol 2000;176:356–60CrossRefGoogle ScholarPubMed