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Carotid body tumor ( kasr l p.493 + schwartz P.849) - Coggle Diagram
Carotid body tumor ( kasr l p.493 + schwartz P.849)
DD
Midline swellings
Submandibular triangle swellings
Carotid triangle swellings
Post. triangle swelling
Other swellings
Def.
A rare lesion of the neuroendocrine system
Malignant tumour that arise from chemoreceptors at carotid a. bifurcation
Other names paraganglioma, glomus tumor, or chemodectoma.
CP
Slowly growing swelling at carotid triangle of the neck
occur in middle aged
Smooth surface but may be lobular
Moves from side to side but not vertically
transmitted pulsations from carotid a.
5% to 7% of carotid body tumors are malignant.
Diagnosis
Angiography
Splaying of carotid bifurcation
Biopsy even FNAC is contraindcated
Carotid duplex scan can localize the tumor to the carotid bifurcation, but CT or MRI is usually required to further delineate the relationship of the tumor to the adjacent structures.
Shamblin classification
I, tumor is less than 5 cm and relatively free of vessel involvement
II, tumor is intimately involved but does not encase the vessel wall
III, tumor is intramural and encases the carotid vessels and adjacent nerves
With good resolution CT and MRI, arteriography is usually not required.
However, arteriography can provide an assessment of the vessel invasion and intracranial circulation and allows for preoperative embolization of the feeder vessels, which has been reported to reduce intraoperative blood loss.
TTT
Excion with preservation
Internal carotid excision with synthetic graft
Anatomy of carotid body
The carotid body originates from the third branchial arch and from neuro-ectodermal derived neural crest lineage.
The normal carotid body is located in the adven- titia or periadventitial tissue at the bifurcation of the common carotid artery.
The gland is innervated by the glossopharyngeal nerve. Its blood supply is derived predominantly from the external carotid artery but can also come from the vertebral artery.