Etiology and treatment of carotid body tumor

Carotid body tumor is a chemoreceptor tumor that occurs at the bifurcation of common carotid artery. It is a benign tumor with slow growth, and a few can become malignant. There is no difference between age and sex.

Pathological carotid body is located after the bifurcation of the common carotid artery, and is connected with the arterial wall through connective tissue. It varies in size, with an average diameter of about 3.5mm, flat oval or irregular pink tissue. It is the largest accessory ganglion in human body and contains chemoreceptors. Its main function is to feel the change of carbon dioxide concentration in blood. When the concentration of carbon dioxide rises, reflection will lead to faster and deeper breathing. After the formation of carotid body tumor, the tumor is brownish red, round or oval with complete capsule. Microscopically, tumor cells are arranged, and blood vessels are rich in matrix components. The tumor cells are polygonal with small nuclei.

Clinical manifestations: painless mass in the neck, located in the carotid triangle, grows slowly and has a history of several years or decades. If malignant transformation occurs, the lump will grow rapidly in a short time. When the mass is small, it is generally asymptomatic, or there is only a slight local pressure. When the mass is large, it can compress adjacent organs and nerves, leading to hoarseness, dysphagia, tongue atrophy, tongue extension deviation, dyspnea and Horner syndrome.

The diagnosis mass is located in the triangle of carotid artery, which is round, slow growing, hard in texture, clear in boundary, movable left and right, and limited in up and down movement. Superficial masses can touch the pulse of blood vessels, and sometimes vascular murmurs can be heard. The possibility of carotid body tumor should be considered. B-ultrasound and DSA are of great value in the diagnosis of this disease. B-ultrasound showed that the mass at the bifurcation of carotid artery separated the internal carotid artery from the external carotid artery, and the distance between them widened. DSA showed that the tumor was located behind the carotid artery, pushing the bifurcation of the common carotid artery forward, widening the bifurcation of the carotid artery and enriching the tumor blood vessels.

The treatment is subcutaneous tumor resection. Because the tumor originated from the carotid body connected with the carotid adventitia, it has extremely rich blood supply and is close to the carotid artery, vein and nerve, so the operation is difficult. Prepare for blood transfusion before operation and operate carefully during operation to avoid accidents. If the tumor is large, adheres to or surrounds the carotid artery, the tumor should be removed together with part of the carotid artery, and then the artery should be anastomosed end to end. Surgery is dangerous. Therefore, there is a view that surgical resection is generally not allowed unless the tumor becomes malignant.