Zhang Wen-Chao, Cheng Jun-Ping, Li Qiang, Zhang Lun, Wang Xu-Dong, Anniko Matti
Department of Head and Neck Surgery, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Tiyanbei, Tianjin, PR China.
Acta Otolaryngol. 2009 Nov;129(11):1320-5. doi: 10.3109/00016480802660510.
Malignant carotid body tumour (MCBT) is a clinically rare disease that often invades the carotid artery and cranial nerves. Diagnosis of malignant tumour should be based on extensive invasion of neighbouring organs and distant metastasis. Extensive resection should be undertaken early. Radiotherapy is effective, whereas chemotherapy is uncertain.
To summarize the clinical pathological and prognostic characteristics of MCBT and explore methods for diagnosis and treatment.
The study material comprised clinical, pathological, therapeutic and follow-up data concerning nine patients (four males, five females) with MCBT, treated at Tianjin Cancer Hospital between January 1956 and June 2006. The material was analysed retrospectively. Disease duration averaged 6.4 years. Shamblin classification was: one case, type II; 8 cases, type III. All nine patients underwent ultrasound examination, four underwent digital subtraction arteriography (DSA) and three had magnetic resonance angiography (MRA). Five patients underwent preoperative training of compression of the carotid (Matas test). Extensive resection was performed in all nine cases.
The carotid artery was blocked in three patients. In one of these the artery was reconstructed with a vascular prosthesis, while two underwent carotid ligation. Eight patients suffered from a cranial nerve dysfunction (defect) and two suffered postoperatively from a hoarse voice, four had a glossal deviation, five had Horner's syndrome and one had a deviation of the lip angle. One patient had a congestive cough. The histopathological diagnosis in all nine cases was MCBT. One patient had metastases to a cervical lymph node and lung and another had liver metastasis. The median follow-up period was 3 years (range 6 months to 14 years). Six patients survived surgery, of whom two underwent radiotherapy. Two patients died and one could not be traced.
恶性颈动脉体瘤（MCBT）是一种临床罕见疾病，常侵犯颈动脉和颅神经。恶性肿瘤的诊断应基于对邻近器官的广泛侵犯和远处转移。应尽早进行广泛切除。放射治疗有效，而化疗效果不明确。
总结MCBT的临床病理及预后特征，探讨其诊断和治疗方法。
研究材料包括1956年1月至2006年6月在天津医科大学肿瘤医院接受治疗的9例MCBT患者（4例男性，5例女性）的临床、病理、治疗及随访数据。对该材料进行回顾性分析。病程平均为6.4年。Shamblin分类为：1例II型；8例III型。所有9例患者均接受了超声检查，4例接受了数字减影血管造影（DSA），3例进行了磁共振血管造影（MRA）。5例患者接受了颈动脉压迫术前训练（Matas试验）。所有9例均行广泛切除。
3例患者颈动脉闭塞。其中1例行血管假体重建动脉，2例行颈动脉结扎。8例患者出现颅神经功能障碍（缺损），2例术后声音嘶哑，4例舌偏斜，5例霍纳综合征，1例口角偏斜。1例患者有充血性咳嗽。9例患者的组织病理学诊断均为MCBT。1例患者出现颈部淋巴结和肺转移，另1例有肝转移。中位随访期为3年（范围6个月至14年）。6例患者术后存活，其中2例接受了放射治疗。2例患者死亡，1例失访。
