Kuy SreyRam
An Assistant Professor of Surgery at Louisiana State University-Shreveport.
Overton Brooks Veterans Affairs Medical Center.
J La State Med Soc. 2015 Jul-Aug;167(4):165. Epub 2015 Aug 15.
A 46-year-old woman noted a right-sided neck lump one year ago. A CT scan demonstrated a right-sided 2 cm mass located between the external and internal carotid arteries that enhanced with contrast and caused splaying of the carotid bifurcation, suggesting a carotid body tumor (Figure A). She had no neurological symptoms. She underwent surgical excision of the mass, without trauma to the carotid vessels and care was taken to identify the Hypoglossal and vagus nerves. Intraoperatively, the mass was found to be supplied by several small vessels from the external carotid artery but without any attachment to the arterial walls (Figure B), consistent with a Shamblin Class 1 carotid body tumor. Hematoxylin and eosin stains showed nests of cells with eosinophilic cytoplasm separated by a hyalinized stroma, with no evidence of anaplasia or invasion, consistent with a Paraganglioma. Postoperatively she recovered with no complications. Surgical excision remains the only curative treatment for this type of tumor, and recurrence is rare.
一名46岁女性一年前发现右侧颈部有一肿块。CT扫描显示右侧有一个2厘米的肿块,位于颈外动脉和颈内动脉之间,增强扫描时有强化,并导致颈动脉分叉处增宽,提示为颈动脉体瘤(图A)。她没有神经症状。她接受了肿块的手术切除,术中未损伤颈动脉血管,并小心辨认了舌下神经和迷走神经。术中发现肿块由颈外动脉的几条小血管供血,但与动脉壁无任何附着(图B),符合Shamblin 1级颈动脉体瘤。苏木精-伊红染色显示细胞巢被玻璃样化的间质分隔,胞质嗜酸性,无间变或浸润证据,符合副神经节瘤。术后她恢复良好,无并发症。手术切除仍然是这类肿瘤唯一的治愈性治疗方法,复发罕见。