CAROTID BODY TUMOR MASQUERADING AS AN ISOLATED SUBMANDIBULAR LYMPH NODE- A CASE REPORT AND LITERATURE REVIEW
DOI:
https://doi.org/10.29121/granthaalayah.v4.i11.2016.2416Keywords:
Cervical lymph node, Paraganglioma, Chemodectoma, Shamblin, Carotid Body TumorAbstract [English]
Carotid body tumors (CBT) are very rare tumors and CBT masquerading as a submandibular lymph node are even rarer. The authors report a case of a middle aged male who was referred to the Otolaryngology department for investigation of a suspected/ apparent left submandibular lymph node. It was slow growing in nature, painless and firm to the touch but was otherwise asymptomatic. Given this presentation and his history of smoking two (2) packs of cigarettes a day for fifty-three (53) years a malignancy of the head and neck area was suspected. A Fine Needle Aspiration Cytology (FNAC) was done at his first visit and this was negative for malignancy. A Computed Tomography (CT) scan of the neck revealed a mass within the carotid sheath with the characteristic Lyre sign: the splaying of the internal and external carotid arteries typical of a paraganglioma or chemodectoma. Based on the recommendations of Shamblin, this case was classified as a Shamblin I, i.e. a perfect candidate for surgical resection. After adequate preparation, informed consent and further imaging, the tumor was resected an uneventful recovery was to be in keeping with the dictum of the Shamblin classification. The histology was reported as a Paraganglioma with no atypical features. We think this is the first reported case of CBT from the Caribbean countries.
Downloads
References
Wieneke J, Smith A. Paraganglioma: Carotid Body Tumor. Head Neck Pathol. 2009 Dec; 3(4):303–306. doi: 10.1007/s12105-009-0130-5. DOI: https://doi.org/10.1007/s12105-009-0130-5
Irving R, Martin T. Paragangliomas. In Watkinson J, Gilbert R, editors. Stell and Maran's Textbook of Head and Neck Surgery and Oncology. Boca Raton, Florida: CRC Press, Taylor and Francis Group; 2012. DOI: https://doi.org/10.1201/b13389-17
Moore M, Netterville J, Mendenhall W, Isaacson B, Nussenbaum B. Head and Neck Paragangliomas: An Update on Evaluation and Management. Otolaryngol Head Neck Surg. 2016 February; 154(4). ):597-605. doi: 10.1177/0194599815627667. Epub 2016 Feb 9. DOI: https://doi.org/10.1177/0194599815627667
Gad A, Sayed A, Elwan H, Fouad F, Eldin H, Khairy H, et al. Carotid Body Tumors: A Review of 25 years experience in diagnosis and management of 56 tumors. Annals of Vascular Diseases. 2014 August; 7(3). DOI: https://doi.org/10.3400/avd.oa.13-00116
Duncan D, McDonald J. Chemodectoma(NonchromaffinParaganglioma) Of The Mediastinum. Annals of Surgery. Aug 1954. DOI: https://doi.org/10.1097/00000658-195408000-00019
Mulligan, R.M. Chemodectoma in the dog(Abstr.). Am. J. Path., 26: 680-681,1950.
Milner R., Babrowski T. Carotid Body Tumours. Thompson M., editor. Oxford Textbook of Vascular Surgery. Oxford, United Kingdom: Oxford University Press. 2016 DOI: https://doi.org/10.1093/med/9780199658220.003.0044
Singh D, Jaydip R, Rajani. Management for Carotid Body Tumors: A Single Center Experience. Indian J VascEndovascSurg 2014;1:8-11 DOI: https://doi.org/10.4103/0972-0820.142356
Saldana MJ, Salem LE, Travezan R: High altitude hypoxia and chemodectomas. Hum Pathol. 1973, 4: 251-263. DOI: https://doi.org/10.1016/S0046-8177(73)80012-7
Leidenz FB, Bastos-Rodrigues L, Oliveira M, Mamede M, Sarquis M, Friedman E, de Marco L.Malignant phenotype and two SDHD mutations in a family with paraganglioma syndrome type 1.Genet Res (Camb). 2015 Mar 30;97:e3. doi: 10.1017/S0016672315000063 PMID: 25819804. DOI: https://doi.org/10.1017/S0016672315000063
Kaygusuz I1, Karlidag T, Keles E, Yalcin S, Yüksel K Carotid Body Tumor: Clinical Features. J Craniofac Surg. 2015 Oct;26(7):e586-9. DOI: https://doi.org/10.1097/SCS.0000000000002003
Luna-Ortiz K, Rascon-Ortiz M, Villavicencio-Valencia V, Herrera-Gomez A. Does Shamblin's classification predict postoperative morbidity in carotid body tumors? A proposal to modify Shamblin's classification. Eur Arch Otorhinolaryngol. 2006 Feb; 263(2):171-5. Epub 2005 Jul 12. DOI: https://doi.org/10.1007/s00405-005-0968-4
Lazar B DavidovicVojko B Djukic Dragan M Vasic, Radomir P Sindjelic and Stevo N Duvnjak. Diagnosis and treatment of carotid body paraganglioma: 21 years of experience at a clinical center of Serbia World Journal of Surgical Oncology20053:10 DOI: 10.1186/1477-7819-3-10January 2005Volume 41, Issue 1, Pages 56–61
Chand P, Singh R, Singh B, Singla RL. Carotid Body Tumor Presenting as Parotid Swelling Misdiagnosed as Pleomorphic Adenoma: A Rare Presentation. Niger J Surg. 2015 Jul-Dec;21(2):157-8. doi: 10.4103/1117-6806.162588. DOI: https://doi.org/10.4103/1117-6806.162588
Wang, S., Chiu K., Cheng P. Bilateral carotid body paragangliomas. CMAJ. 2011 Jun 14; 183(9): E606. doi: 10.1503/cmaj.092114 DOI: https://doi.org/10.1503/cmaj.092114
Budincevic H1, Piršic A, Bohm T, Trajbar T, Ivkošic A, Pavlovic T, Bielen I, Soldo-Butkovic S. Carotid Body Tumor as a Cause of Stroke. Intern Med. 2016;55(3):295-8. doi: 10.2169/internalmedicine.55.5350. Epub 2016 Feb 1 DOI: https://doi.org/10.2169/internalmedicine.55.5350
Chamorro Sanchez A, Varela de Seijas E, MatesanzMatesanz J, Trapero VL. Carotid body tumor: unusual cause of transient ischemic attacks.Stroke. 1988 Jan;19(1):102-3. DOI: https://doi.org/10.1161/01.STR.19.1.102
Fudim M1, Groom KL2, Laffer CL3, Netterville JL2, Robertson D4, Elijovich F Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients.J Am SocHypertens. 2015 Jun;9(6):435-42. doi: 10.1016/j.jash.2015.03.006. Epub 2015 Mar 19. DOI: https://doi.org/10.1016/j.jash.2015.03.006
Da Silva D, O’Donnel S, Gillespie D, Goff J, Shriver C,Rich N. Malignant Carotid Body Tumor:a case report. J Vasc Surg. 2000 Oct; 32(4): 821-3. DOI: https://doi.org/10.1067/mva.2000.107766
Pacheco-Ojeda L. Malignant carotid body tumors: report of three cases. Annals of Otology, Rhinology and Laryngology. 2001;110(1):36–40. doi: 10.1177/000348940111000107. [PubMed] DOI: https://doi.org/10.1177/000348940111000107
Sajid MS, Hamilton G, Baker DM. A Multicenter Review of Carotid Body Tumour Management. Eur J VascEndovasc Surg. 2007 August; 34(2). DOI: https://doi.org/10.1016/j.ejvs.2007.01.015
Naik S, Shenoy A, Nanjundappa ,Halkud R. Paragangliomas of the Carotid Body: Current Management Protocols and Review of Literature. Indian J SurgOncol. 2013 September; 4(3). DOI: https://doi.org/10.1007/s13193-013-0249-4
Power A, Bower T, Vrtiska T, Duncan A,Kalra M, Oderich G, Gloviczki P. Imaging Predictors of Cranial Nerve Injury in Carotid Body Tumor Resections. J VascSurg June 2012; Vol 55(6): Supp. 91S-92S. DOI: https://doi.org/10.1016/j.jvs.2012.03.220
Straughan DM, Neychev VK, Sadowski SM, Ellis RJ, Thomas F, Patronas NJ, Pacak K, Kebebew E, Nilubol N. Preoperative Imaging Features are Associated with Surgical Complications Following Carotid Body Tumor Resection. World J Surg. 2015 Aug;39(8):2084-9. doi: 10.1007/s00268-015-3058-9. PMID: 25840820. DOI: https://doi.org/10.1007/s00268-015-3058-9
Shamblin W. R., ReMine W. H., Sheps S. G., Harrison E. G., Jr. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. The American Journal of Surgery. 1971;122(6):732–739. doi: 10.1016/0002-9610(71)90436-3. DOI: https://doi.org/10.1016/0002-9610(71)90436-3
Galyfos G, StamatatosI,Kerasidis S, Stefanidis I, Giannakakis S, Kastrisios G, GeropapasG,Papacharalampous G, and MaltezosC.Multidisciplinary Management of Carotid Body Tumors in a Tertiary Urban Institution10. Int J Vasc Med. 2015; 2015: 969372. Published online 2015 Dec 9. doi: 10.1155/2015/969372 DOI: https://doi.org/10.1155/2015/969372
Arya S., Rao V., Juvekar S., Dcruz A. K. Carotid body tumors: objective criteria to predict the Shamblin group on MR imaging. American Journal of Neuroradiology. 2008;29(7):1349–1 354. doi: 10.3174/ajnr.a1092. DOI: https://doi.org/10.3174/ajnr.A1092
Lim J, Kim J, Kim S, Lee S. Surgical Treatment of Carotid Body Paragangliomas: Outcomes and Complications According to the Shamblin Classification. ClinExpOtorhinolaryngol. 2010 June; 3(2). DOI: https://doi.org/10.3342/ceo.2010.3.2.91
Law Y, Chan YC, Cheng SW. Surgical management of carotid body tumor - Is Shamblin classification sufficient to predict surgical outcome? Vascular. 2016 Jun 29. pii: 1708538116657504. [Epub ahead of print] DOI: https://doi.org/10.1177/1708538116657504
Mayer 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. StrahlentherOnkol. 2000, 176: 356-360. DOI: https://doi.org/10.1007/PL00002343
Downloads
Published
How to Cite
Issue
Section
License
With the licence CC-BY, authors retain the copyright, allowing anyone to download, reuse, re-print, modify, distribute, and/or copy their contribution. The work must be properly attributed to its author.
It is not necessary to ask for further permission from the author or journal board.
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.