Nonresectable carotid body tumor: hybrid surgical procedure to achieve complete and safe resection.
BACKGROUND
Carotid body tumors of Shamblin class III without free internal carotid, between the tumor and skull base, are considered nonresectable. The objective of this work is to describe a surgical technique that combines traditional and endovascular strategies to achieve a safe surgical resection of the carotid body tumor of this class.


RESULTS
A female patient with a nonresectable carotid body tumor underwent placement of an endoprosthesis going from the common carotid artery to the internal carotid beyond the skull base (to secure cerebral circulation) excluding the external carotid artery. Forty-five days later, the tumor was resected without vascular or cranial nerves injury, and bleeding amounted to 50 cm(3). At 6 months, the patient is tumor free and asymptomatic.


CONCLUSIONS
This is the first known reported case that has been successfully resolved by combining endovascular and traditional strategies. The endoprosthesis maintained cerebral circulation, which otherwise would have been impossible; besides, the vascular supply from the external carotid artery was excluded leading to a decrease in tumor size and a recovery of the sub-adventitial dissection plane, allowing for a successful and safe tumor resection.
Hurtado-Lopez
Luis Mauricio
LM
Department of General Surgery, Head and Neck, Hospital General de México, Mexico City, Mexico. hurtado@clinicadetiroides.com.mx
Fink-Josephi
Gustavo
G
Ramos-Méndez
Luis
L
Dena-Espinoza
Ernesto
E
D001807:Blood Vessel Prosthesis; D002345:Carotid Body Tumor / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*