Surgical treatment of paragangliomas of the carotid bifurcation: results of 36 patients.
BACKGROUND
Paragangliomas of the carotid bifurcation are rare and usually benign neoplasms arising from the carotid body chemoreceptors. The aim of this retrospective study was to report long-term results of carotid bifurcation paragangliomas treated in a single institution over a period of 20 years. The following variables are described: age, sex, localization, diagnostic workup, operative procedure, complications, proportion and characteristics of malignant tumors, and cure rates.


METHODS
Thirty-six patients,10 men and 26 women, were treated. Twenty-three patients had tumors on the right side, 10 patients had tumors on the left side, and three patients had bilateral tumors. All patients were symptomatic. The most common complaint was a neck mass that had been present for 1 to 144 months. All patients had diagnostic procedures done before treatment. The most widely used was ultrasonography (26 patients). Angiography was performed in 14 patients.


RESULTS
All patients underwent complete tumor resection. In three cases, resection of the internal carotid was necessary. In all patients who underwent internal carotid resection, immediate reconstruction was performed. No patients had postoperative strokes. Five patients had postoperative nerve palsies. During the follow-up period of 4 months to 12 years, no patients had local recurrence develop. Four patients had distant metastasis.


CONCLUSIONS
The complete removal of paragangliomas of the carotid bifurcation is effective with acceptable morbidity. All recurrences of the malignant tumors were distant metastasis.
Department of Head and Neck Surgery and Otorhinolaringology, Hospital do Câncer A C Camargo, São Paulo, SP, Rua Professor Antônio Prudente, 211, 01509-900 São Paulo, Brazil.
Hugo Fontan
HF
Köhler
André Lopes
AL
Carvalho
Nara V
NV
Mattos Granja
Kenji
K
Nishinari
Luiz Paulo
LP
Kowalski
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery; D002345:Carotid Body Tumor / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*