Condition Overview
Carotid body tumors (CBTs), also known as paragangliomas, are rare, typically benign tumors that arise from the carotid body, a small cluster of chemoreceptor cells located at the bifurcation of the carotid artery. These tumors are highly vascular. While most CBTs are benign, they can sometimes be malignant and have potential for local invasion and distant metastasis. There is also a genetic component to many of these carotid body tumors, and so genetic testing is often appropriate.
Carotid body tumors often present as a painless, slowly growing mass in the neck, which may be noticed by the patient or during a physical examination. As the tumor enlarges, it can cause symptoms due to compression of nearby structures, including difficulty swallowing (dysphagia), hoarseness, and symptoms related to cranial nerve involvement such as Horner's syndrome. In some cases, these tumors can secrete catecholamines, leading to symptoms such as high blood pressure, headaches, and palpitations.
Diagnosis typically involves imaging studies such as ultrasound, CT scan, MRI, and angiography to assess the size, location, and vascularity of the tumor. Fine-needle aspiration biopsy is generally avoided due to the high vascularity of these tumors.
Treatment Options
- Excision of the Carotid Body Tumor
- Description: The preferred management approach is to remove the tumor. This requires an experienced team given that bleeding can be significant.
- Indications: symptomatic carotid body tumor, desire to treat definitively.
- External Beam Radiation Therapy (EBRT)
- Description: For patients who are very poor surgical candidates but have symptomatic CBTs, radiation can rarely be considered. It is not the standard therapy, and is usually avoided.
- Indications: poor surgical candidate but still requires some treatment
Management of carotid body tumors requires a multidisciplinary approach involving a head and neck surgeon with insight from radiology and sometimes genetics. Early diagnosis and appropriate treatment are crucial to manage symptoms and prevent complications associated with these tumors. Having an experienced team such as that at the Russell Center ensures that you will have access to the widest range of options for your carotid body tumor.
