Amsalu Ashenafi, Anderson Bernard, Tesfaye Wegahta
Ethiop Med J. 2013 Oct;51(4):285-91.
The Carotid Body Tumor (CBT) should be considered in the differential diagnosis of any patient with an anterior lateral neck mass (mass in the region of carotid artery bifurcation) even though it is a rare neoplasm. Physical findings that support the diagnosis include pulsation without expansile palpation and the ability to move the mass from side to side but not vertically. The diagnosis is supported further by radiological procedures that may include US, CT, MRI and arteriography. Once the diagnosis is made, surgery is the principal treatment and the only curative modality but has inherent risks for hemorrhage and stroke for which the patient should be informed. Radiation therapy has been shown to be an alternative to surgery in certain patients and an adjunct to surgery in others. The internal carotid artery may need to be resected in order to remove the tumor. The surgeon needs to be prepared to employ intraoperative stump pressure manometry, to use intravascular shunts and be familiar with the several diagnostic and reconstructive vascular techniques relevant to this area, any of which may be needed to ensure adequate cerebral perfusion thereby reducing the risk of stroke and death that may attend simple ligation of the internal carotid artery. Regional anesthesia has proven benefit in carotid endarterectomy surgery. This technique may have a role in CBT surgery. In this paper we present an encounter with a giant malignant carotid body tumor and a brief review of CBTs in the English literature.
即使颈动脉体瘤（CBT）是一种罕见的肿瘤，但对于任何患有颈前外侧肿块（颈动脉分叉区域的肿块）的患者，在鉴别诊断时都应考虑到它。支持该诊断的体格检查结果包括有搏动但触诊无扩张感，以及肿块可左右移动但不能上下移动。放射学检查程序（可能包括超声、CT、MRI和动脉造影）可进一步支持诊断。一旦确诊，手术是主要治疗方法也是唯一的治愈方式，但存在出血和中风的固有风险，应告知患者。在某些患者中，放射治疗已被证明可替代手术，在其他患者中可作为手术的辅助治疗。为了切除肿瘤，可能需要切除颈内动脉。外科医生需要准备好采用术中残端压力测量法、使用血管内分流器，并熟悉与该区域相关的几种诊断和重建血管技术，可能需要其中任何一种来确保足够的脑灌注，从而降低单纯结扎颈内动脉可能带来的中风和死亡风险。区域麻醉在颈动脉内膜切除术中有已被证实的益处。该技术可能在CBT手术中发挥作用。在本文中，我们介绍了一例巨大恶性颈动脉体瘤病例，并对英文文献中的CBT进行了简要综述。
