Presentation and Management of Carotid Body Tumors

Objective: To review the presentation, management and outcome of carotid body tumors at a University Hospital in Karachi. Setting: The Aga Khan University Hospital, Karachi a tertiary care hospital in Pakistan. Methods: The medical records of all the patients who were admitted between 1st January1991 to 1st January 2002, with a diagnosis of carotid body tumor and underwent surgical resection, were identified using the ICD-9CM coding system. The variables reviewed included demographic features, clinical presentation, diagnosis, management and outcome. The data was analyzed using the student t-test for continuous variables and the Fischer Exact test for categorical data, with computer-based SPSS version 10 software package. Results: A total of 8 patients with 8 carotid body tumors were treated surgically during the study period of 11 years. The study group consisted of 6 males and 2 females with a median age of 46 years (range: 26-68 years). All the eight patients presented with a history of neck mass which was progressively increasing in size. Physical examination revealed well-circumscribed firm masses at the angle of jaw in 6 patients. The other two patients had large tumors extending to the base of skull. The mainstay of final diagnosis was angiography, which was performed in all 8 patients. Pre-operative angio-embolization was done in three patients; followed by complete surgical resection in all 8 patients. There was no peri-operative mortality or stroke in these patients. Transient nerve palsies involving 7th and 12th cranial nerves were noted in three patients. One patient had permanent unilateral vocal cord palsy resulting in hoarseness of voice. Median follow up was 1 year with range from 8 weeks to 3 years; none of the patients had any recurrence during the follow-up period. Conclusions: Surgical resection of the carotid body tumors can be performed in suitable patients without major morbidity and mortality. There is a small but definite risk of neurologic complications, which should be clearly explained to the patients. Pre-operative angio-embolization facilitates surgery and reduces operative complications (JPMA 53:306;2003).