Sarafoleanu C, Badea C, Lupoi D
"Sfanta Maria" Clinical Hospital, ENT&HNS Department, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Acta Endocrinol (Buchar). 2023 Jan-Mar;19(1):133-141. doi: 10.4183/aeb.2023.133. Epub 2023 Aug 14.
Paragangliomas are rare neuroendocrine slow-growing tumors, often asymptomatic, that originate from embryonic neural crest cell. In the head and neck area, the most common location is the carotid body, followed, with decreasing frequency, in jugular, tympanic and vagal sites. Bilateral carotid body tumors are extremely rare.
To present the most important features of carotid body paragangliomas, illustrating the clinical characteristics, associated with a thorough analysis of the diagnostic imaging elements, but also the current therapeutic strategies, with respective anatomical, surgical considerations and potential complications that can occur. Surgical resection is the main line of treatment. The complex anatomy of the cervical region and the close relationships of carotid body paragangliomas with carotid vessels and cranial nerves, as well as its intense vascularization makes the surgical intervention a real challenge even for an experienced surgeon.
Starts from a bilateral carotid paraganglioma in a 35-year-old male, with painless lateral neck swelling, accidentally discovered by his barber about two years ago. Diagnosis was suspected on the basis of history, clinical and radiological findings. "Wait and scan" strategy plus endocrinologic assessment for MEN syndromes were considered the optimal therapeutic approach in this case.
副神经节瘤是一种罕见的神经内分泌性生长缓慢的肿瘤,通常无症状,起源于胚胎神经嵴细胞。在头颈部区域,最常见的部位是颈动脉体,其次是颈静脉、鼓室和迷走神经部位,其发生频率依次降低。双侧颈动脉体瘤极为罕见。
介绍颈动脉体副神经节瘤的最重要特征,阐述其临床特点,并对诊断性影像学要素进行全面分析,同时介绍当前的治疗策略、各自的解剖学、手术注意事项以及可能发生的潜在并发症。手术切除是主要的治疗方法。颈部区域复杂的解剖结构以及颈动脉体副神经节瘤与颈动脉血管和颅神经的密切关系,再加上其丰富的血管供应,使得即使对于经验丰富的外科医生来说,手术干预也是一项真正的挑战。
以一名35岁男性的双侧颈动脉副神经节瘤为例展开讨论,该患者颈部外侧有无痛性肿胀,约两年前被其理发师意外发现。根据病史、临床和影像学检查结果怀疑诊断。在这种情况下,“观察并扫描”策略加上对MEN综合征的内分泌评估被认为是最佳治疗方法。