2017 Volume 30 Issue 2 Pages 251-256
Carotid body tumor is a paraganglioma that develops from carotid artery corpuscles, and surgical treatment is required for radical cure. It is a disease that is difficult to deal with because it involves risk of bleeding from the tumor, carotid artery injury, subcranial neuropathy. We reported that it was safe to perform ablation using ultrasonic energy device and blood vessel micro clip in a relatively short time. A case was a 38-year-old female. The chief complaint was left cervical swelling and was introduced to our department for the purpose of review. Contrast CT, contrast MRI and neck ultrasonography revealed that there was a tumorous lesion with a maximum diameter of 48 mm on the bifurcation of the left carotid artery, which was polyhomogeneous and non-uniformly contrasted. We diagnosed it as a carotid body tumor. Distant metastasis was not observed with chest abdominal contrast CT. As a result of Balloon Matas test, no cranial nerve symptoms were observed. Surgical excision was chosen.
Angiography was performed on the day of surgery, and significant carotid angiography revealed marked tumor contamination. We embolized the main feeder, the ascending pharyngeal artery. The tumor surrounded the left internal carotid artery and the external carotid artery and was Group III of the Shamblin class. Despite embolization, the external carotid artery was dissected because of the abundance of nutrient blood vessels from the external carotid artery system. However, bleeding could be controlled by using an energy device. The operation time was 3 hours 52 minutes and the bleeding volume was 322 ml. Postoperative brain neurological symptoms were recognized. In this case, it was possible to perform surgery with safe and relatively small bleeding by using energy device and blood vessel micro clip.
