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颈动脉体瘤的诊断与治疗

Diagnosis and treatment of carotid body tumors.

作者信息

Rabl H, Friehs I, Gutschi S, Pascher O, Koch G

机构信息

Department of Vascular Surgery, University of Graz, Austria.

出版信息

Thorac Cardiovasc Surg. 1993 Dec;41(6):340-3. doi: 10.1055/s-2007-1013886.

Abstract

Carotid body tumors are rare although they must always remain part of the differential diagnosis of a neck mass. Sonography as the screening method of choice followed by angiography determines the diagnosis. In 11 patients 12 carotid body tumors were extirpated. The reconstruction of the internal carotid artery with an interposition of the greater saphenous vein was necessary in two cases after resection of the tumor. One patient underwent preoperative embolisation because of a huge tumor. Two postoperative radiotherapies were undertaken because of malignancy in one case and a partially extirpated tumor in the other. After a 9 year follow-up period all patients are alive. One patient suffers from a persistent palsy of the hypoglossal nerve and another complains of permanent headache supposedly caused by the reocclusion of the venous interposition of the carotid artery. In conclusion, our data support the diagnostic strategies in patients with suspected carotid body tumors. Regarding the exact therapeutic regimen, we suggest the surgical resection, followed by radiotherapy in cases of confirmed malignancy or partially resectable lesions.

摘要

颈动脉体瘤虽然罕见,但在颈部肿块的鉴别诊断中始终应将其纳入考虑范围。超声作为首选的筛查方法,随后进行血管造影以明确诊断。11例患者共切除12个颈动脉体瘤。2例患者在肿瘤切除后需要用大隐静脉移植重建颈内动脉。1例患者因肿瘤巨大接受了术前栓塞。1例患者因肿瘤恶性,另1例因肿瘤部分切除后进行了2次术后放疗。经过9年的随访,所有患者均存活。1例患者出现舌下神经持续性麻痹,另1例患者抱怨持续头痛,推测是由于颈动脉静脉移植再闭塞所致。总之,我们的数据支持对疑似颈动脉体瘤患者的诊断策略。关于确切的治疗方案,我们建议手术切除,对于确诊为恶性或部分可切除病变的患者,术后进行放疗。

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