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Successful treatment of a rare metastatic malignant carotid body tumour in a young adult, with conservative surgery and local radiotherapy

Published online by Cambridge University Press:  28 October 2011

J Williamson ,
G Leopold ,
V Prabhu  and
D Ingrams
J Williamson*
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
G Leopold
Affiliation:
Department of Histopathology, University Hospital of Wales, Cardiff, Wales, UK
V Prabhu
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
D Ingrams
Affiliation:
Department of Otolaryngology, Royal Gwent Hospital, Newport, UK
*
Address for correspondence: Mr J Williamson, Department of ENT, Royal Gwent Hospital, Newport NP20 2UB, Wales, UK E-mail: jswilliamson@doctors.org.uk
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Abstract

Objective:

We report a patient with a malignant carotid body paraganglioma treated with surgery and adjuvant radiotherapy. We discuss her treatment and outcome in the light of the published literature.

Case report:

A 26-year-old woman presented with a 12-month history of a painless, left-sided neck lump. Ultrasound, computed tomography and magnetic resonance imaging revealed a carotid body tumour, which at surgical excision was found to be adherent to the vagus and hypoglossal cranial nerves (X and XII). The tumour was resected from the surrounding structures. Two local lymph nodes were removed to allow access. The internal carotid artery was also involved and had to be repaired with a synthetic graft. Histology and immunohistochemistry confirmed malignant carotid body paraganglioma. There were positive resection margins, and cervical lymph node metastasis was reported in one of the two nodes. Post-operatively, she had left Horner's syndrome, left vocal fold palsy and right upper limb weakness, all of which resolved spontaneously. She underwent adjuvant radiotherapy and remained recurrence free after 30 months.

Conclusion:

Malignant carotid body paraganglioma can affect young adults, with an insidious onset of symptoms. In this patient, local excision (without neck dissection) and adjuvant radiotherapy were well tolerated and resulted in satisfactory local disease control.

Keywords

Carotid Body TumourParagangliomaChemodectomaNeoplasm, MalignantSurgical Procedure, Operative
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 428 - 431
Copyright
Copyright © JLO (1984) Limited 2011

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