Carotid Body Tumor-Its Features and Resection Surgery

Abstract

Carotid body tumors (CBTs) are hypervascular tumors with multiple feeding arteries and a unique orientation at the carotid bifurcation. CBT has been recognized as a malignant tumor since the 2017 WHO classification 4th edition (ICD-O code: 8692/3). Although resection surgery potentially offers radical cure for this tumor, complete resection is challenging. Multiple feeding arteries and adhesions of the tumor to the carotid arterial wall pose difficulties in CBT resection surgery. The effectiveness of preoperative embolization remains controversial due to the differing protocols among institutions. However, accurate embolization and resection immediately after embolization could reduce the volume of blood loss and operation time in CBT surgery. Most patients with CBT harbor germline mutations, such as SDHB and SDHD. Conversely, the concept of “hereditary paraganglioma-pheochromocytoma syndrome (HPPS)” has been proposed to describe patients with familial paraganglioma. Therefore, analyses of gene alterations are needed in patients with CBT.