Recent Modalities in Management of Carotid Body Tumors

Abstract

Carotid body tumors are the most common paragangliomas of head and neck (65%). Most of these tumors are benign with a small malignant potential (4.3%).Main clinical presentation is pulsatile painless neck mass at level of thyroid cartilage. Although newer non-invasive diagnostic modalities especially CT carotid Angiography and Magnetic Resonance Angiography have significantly enhanced the diagnostic capabilities, controversy exists over adequate management of these rare tumors. In younger, healthy patients with no comorbidities, the best therapeutic strategy is a complete surgical resection of the tumor. However, in less than ideal patient population modalities such as radiation and transarterial versus direct tumor embolization can be considered. Role of pre-operative carotid artery stenting is under study with good results in some cases. Surgical advances have greatly decreased the mortality rates, but the morbidity rates secondary to cranial nerve injuries remain high.