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伴有完全性心脏传导阻滞的颈动脉体瘤:一例罕见病例报告及长期随访

Carotid body tumor associated with complete heart block: A rare case report with long-term follow-up.

作者信息

Hoseinzadeh Ahmad, Nozari Hamed, Zeraatpisheh Ebrahim, Tajaddini Ali, Mohebbiniya Mohsen, Arani Hamid Zaferani

机构信息

Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Surg Case Rep. 2025 May;130:111216. doi: 10.1016/j.ijscr.2025.111216. Epub 2025 Mar 27.

Abstract

INTRODUCTION

Carotid body tumor (CBT) is one of the most common paragangliomas in the head and neck region, accounting for only 0.6 % of tumors in this area. Here, we present a rare case of CBT associated with congenital complete heart block (CHB).

CASE PRESENTATION

We report the case of a 47-year-old female with a history of left neck and ear pain, accompanied by a gradually enlarging neck mass over 2.5 years. Following initial evaluations and multiple differential diagnoses, CT angiography revealed an oval-shaped mass measuring 30 × 50 mm at the left carotid bifurcation, confirming a Shamblin type II CBT. Preoperative assessments demonstrated congenital CHB on electrocardiogram and echocardiography. The patient underwent complete tumor resection with all necessary precautions, including temporary pacemaker placement and careful monitoring.

CLINICAL DISCUSSION

CBTs are considered rare neoplasms, comprising only 0.6 % of head and neck tumors and approximately 0.03 % of all neoplasms. The surgical outcomes demonstrated that despite the coexistence of a CBT with CHB, safe and successful surgery is possible with careful planning and comprehensive management.

CONCLUSION

This case highlights the importance of precise diagnosis and management in rare combination cases and emphasizes the crucial role of collaboration between vascular surgery and anesthesiology specialists in minimizing surgical risks and improving patient quality of life.

摘要

引言

颈动脉体瘤(CBT)是头颈部最常见的副神经节瘤之一,仅占该区域肿瘤的0.6%。在此,我们报告一例罕见的与先天性完全性心脏传导阻滞(CHB)相关的CBT病例。

病例介绍

我们报告一名47岁女性患者,有左颈部和耳部疼痛病史,2.5年来颈部肿块逐渐增大。经过初步评估和多次鉴别诊断,CT血管造影显示在左颈动脉分叉处有一个椭圆形肿块,大小为30×50mm,确诊为沙姆林II型CBT。术前评估通过心电图和超声心动图显示为先天性CHB。患者在采取了所有必要预防措施的情况下接受了肿瘤完整切除,包括临时起搏器植入和密切监测。

临床讨论

CBT被认为是罕见肿瘤,仅占头颈部肿瘤的0.6%,约占所有肿瘤的0.03%。手术结果表明,尽管CBT与CHB并存,但通过精心规划和综合管理,仍有可能实现安全、成功的手术。

结论

本病例突出了罕见合并症病例精确诊断和管理的重要性,并强调了血管外科和麻醉科专家之间合作在降低手术风险和提高患者生活质量方面的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1197/12002622/fab722f6f2a5/gr1.jpg

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