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颈动脉体副神经节瘤:当前的管理方案及文献综述

Paragangliomas of the carotid body: current management protocols and review of literature.

作者信息

Naik Sudhir M, Shenoy Ashok M, Halkud Rajshekar, Chavan Purshottam, Sidappa K, Amritham Usha, Gupta Sumit

机构信息

Department of Head and Neck Oncosurgery, KMIO, Bangalore, India.

Department of Pathology, KMIO, Bangalore, India.

出版信息

Indian J Surg Oncol. 2013 Sep;4(3):305-12. doi: 10.1007/s13193-013-0249-4. Epub 2013 Aug 15.

Abstract

Paraganglioma is a rare neoplasm arising from carotid body usually benign and constitute 0.5 % of all total body tumors. They constitute 60-70 % of head and neck paraganglioma and resemble other paragangliomas of the body like glomus jugulare, glomus tympanicum, and pheochromocytoma. This is a retrospective analysis of the medical records of carotid body paraganglioma cases. Nine patients operated during the study period and the follow up traced were included in the study. Seven females and 2 males were analysed. Six had tumor on the left side and 3 had on the right side. All the cases surgical excision was done by a tranverse incision as 2 patients had Shamblin I, 5 patients had Shamblin II, and 1 patients Shamblin IIIa. All the Shamblin I had tumor away from the carotids and were easily dissected without vessel damage, a sub adventitial tumor excision was performed in all the 5 cases of Shamblin II, 1 case of Shamblin IIIa was dissected with difficulty without sacrificing or vessel reconstruction. Paraganglioma of the carotid body should be considered as a differential diagnosis for painless lateral neck masses. Larger tumors need a multidisciplinary team of head and neck with vascular surgeons for better results.

摘要

副神经节瘤是一种起源于颈动脉体的罕见肿瘤,通常为良性,占全身肿瘤的0.5%。它们占头颈部副神经节瘤的60% - 70%,与身体其他部位的副神经节瘤相似,如颈静脉球瘤、鼓室球瘤和嗜铬细胞瘤。这是一项对颈动脉体副神经节瘤病例医疗记录的回顾性分析。研究纳入了研究期间接受手术且进行了随访的9名患者。分析了7名女性和2名男性。6例肿瘤位于左侧,3例位于右侧。所有病例均通过横向切口进行手术切除,其中2例为Shamblin I型,5例为Shamblin II型,1例为Shamblin IIIa型。所有Shamblin I型患者的肿瘤远离颈动脉,易于解剖且未损伤血管,所有5例Shamblin II型患者均进行了外膜下肿瘤切除,1例Shamblin IIIa型患者解剖困难,未进行牺牲或血管重建。颈动脉体副神经节瘤应被视为无痛性颈部外侧肿块的鉴别诊断之一。较大的肿瘤需要头颈外科和血管外科的多学科团队来取得更好的治疗效果。

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