Quemodectomas carotídeosexperiencia quirúrgica y revisión de la literatura

Zusammenfassung

Introduction. Carotid paragangliomas (PCs) are rare tumors. They are usually benign and slow growing. We show our experience in patients treated surgically during the past fifteen years and follow-up. Material and Methods: Retrospective and descriptive of the patients operated on from 1996 to 2010. Registration of demographic variables, unilateral or bilateral involvement, personal history and / or relatives, physical examination, diagnostic techniques, surgical procedure performed and / or adjuvant treatment and follow-up data (neurological complications, mortality, pathology and relapse). Results: 29 cases in 26 patients (3 bilateral), 6 males (23.08%) and 20 women (76.92%) with mean age of 64.81 (range 27-82) years. No cases with a family history of paraganglioma. Clinical diagnosis in all cases (left lateral neck mass in 13 cases and right in 16). 7 patients (26.92%) reported dysphagia, dysphonia one (3.85%) and one (3.85%) symptoms resulting from the secretion of catecholamines. Diagnosis by echo-doppler in 100% of cases, using well arteriography, CT and MRI. Treatment by resection of the PC in all cases. Furthermore, in 2 cases (6.90%) vascular reconstruction by Gore-Tex patch and 3 (10.35%) carotid thromboendarterectomy. Preoperative tumor embolization using coils in 3 cases (10.35%). No perioperative mortality. Mean follow-up to 5.1 ± 3.67 years: 23 asymptomatic patients, mild hoarseness in 3. Conclusion: First of all lateral neck mass should suggest the diagnosis of PC. Preserving resection of the cranial nerves is the treatment of choice. In our experience, embolization of no benefit after surgery.