CA: A Cancer Journal for Clinicians, Vol 30, 260-265, Copyright
© 1980 by American Cancer Society
Carotid Body Tumors: A 40-Year Study
Hollon W. Farr M.D.1
1 Attending Surgeon, Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York; and Clinical Associate Professor of Surgery, Cornell University Medical College, New York, New York.
A total of 44 carotid body tumors were observed for over 40 years at Memorial Sloan-Kettering Cancer Center in New York. The true nature of the paraganglioma an remain obscure in those patients without prior tissue biopsy or sophisticated diagnostic studies. Eighteen patients came to surgery without a primary working diagnosis of the condition, 43 percent of the series.
Significant advances in the preoperative workup of a cervical mass attached to the carotid sheath are now recommended: ultrasonography, radioisotope perfusion scanning, and selective carotid arteriography. Catecholamine determination should be considered for any paraganglioma exhibiting vasomotor instability or hypertension.
Prior to 1945 the carotid bifurcation was sacrificed eight times with a 50 percent mortality occurring in relatively youthful subjects. In the 35 years since then, a more sophisticated surgical technique preserving the carotid circulation has resulted in over 30 resections with but one fatality.
Multicentricity, both in the sporadic and the familial form, is characteristic of this rare tumor, also called "APUDoma." (APUD is an acronym derived from three of the most important characteristics of these cells: a high amine content, amine precursor uptake, and decarboxylation.) Its malignant potential is beyond debate.
