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      B-mode and color Doppler imaging of carotid paragangliomas in different neck regions

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          Abstract

          Glomus tumors or paragangliomas are rare benign neoplasms which are very uncommon in the head and neck region. They grow slowly from paraganglion cells, which serve various regulatory tasks in the body and form the basis of the extra-adrenal neuroendocrine system. They have benign properties, but tend to cause local invasion and expansion to adjacent anatomic structures. The majority of glomus tumor cases are incidental findings, since the clinical symptoms are mostly absent. The purpose of this paper is to distinguish the ultrasonographic features of different glomus tumors located within the neck region, based on their varying anatomical location and space occupying behavior.

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          A multicenter review of carotid body tumour management.

          M. Sajid, Laura M S Baker, Graham Hamilton … (2007)
          Carotid body tumour (CBT) is a rare but the most common form of head and neck paraganglioma (PGL). We present the biggest ever series on CBT in UK/EU discussing diagnostic challenges, surgical treatment and complications of surgical intervention. A detailed proforma was designed and sent to all members of Joint Vascular Research Group (JVRG). Data of 95 patients was collected. Generic terms including carotid body tumour/s, or paraganglioma/s were used to search a variety of electronic database in order to get latest informations available in literature. A total of 95 patients were recorded in our data from 1979 to 2005. Mean age of presentation was 55 years. Incidence was higher in females. CBT was more common on right side (58%). 18% tumours were bilateral. Neck lump (98%) and pressure symptoms including cranial nerve deficits and pain were main presenting complaints. About 18% of tumours were familial. Only 4.2% were malignant. Duplex scan is the best investigation for diagnosis, though MRI, DSA and CT scan are important for preoperative assessment. Surgery is the treatment of choice. Stroke and cranial nerve injury constitute postoperative morbidity (35%) and mortality (1%). Incidence of postoperative cranial nerve deficit was about 19%. Combined ipsilateral and contralateral recurrence rate was 4.2%. CBT is a rare condition which needs surgical excision by experienced vascular surgeon. Surgical resection is associated with significant morbidity of 35% and mortality of 1%. Mostly CBT is benign but malignant forms are not uncommon.
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            Vagal paraganglioma: a review of 46 patients treated during a 20-year period.

            David C. Jackson, M E Glasscock, Michael R. Miller … (1998)
            Vagal paragangliomas (VPs) arise from paraganglia associated with the vagus nerve. Approximately 200 cases have been reported in the medical literature. Because of their rarity, most information regarding these tumors has arisen from case reports and small clinical series. To detail the clinicopathologic features of 46 patients with VP with an emphasis on the role of a multidisciplinary skull base team in both the successful extirpation and rehabilitation. Retrospective review of 46 patients with VP managed by a single skull base team. An academic tertiary medical center. Forty-six patients were treated over a 20-year period (1978-1998). Ten (22%) demonstrated intracranial extension. There was a history of familial paragangliomas in 9 (20%) of the patients. The incidence of multicentric paragangliomas was 78% in patients with familial paragangliomas vs 23% in patients with nonfamilial paragangliomas. Management of this group of 46 patients consisted of surgery (n = 40), radiation therapy (n = 4), and observation (n = 2). The operative approach consisted of a transcervical excision often combined with a transtemporal or lateral skull base approach as dictated by the tumor extent. Postoperative cranial nerve deficits were common, and, as such, aggressive rehabilitation was a vital component in the management of these tumors. The management of VP and its associated cranial nerve deficits remains a difficult clinical problem. Options for treatment include surgical resection, radiation therapy, and, in selected cases, observation. Surgical extirpation requires a multidisciplinary skull base team to achieve complete tumor resection. Radiation therapy is reserved for elderly patients and patients at risk for bilateral cranial nerve deficits. Rehabilitation of cranial nerve deficits is an integral part of the management of VP.
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              Carotid body tumors: objective criteria to predict the Shamblin group on MR imaging.

              Mala V. Rao, R. S. Arya, S. Juvekar … (2008)
              MR imaging is an established method for diagnosis and surgical planning of carotid body tumors (CBTs). However no studies have elaborated preoperative objective criteria to predict the Shamblin (surgical) classification of CBTs, an important predictor of vascular morbidity. The purpose of this study was to establish criteria to accurately predict the Shamblin group on preoperative MR imaging for a uniform reporting system. MR images of 9 CBTs in 8 consecutive patients who underwent surgery between 2004 and 2007 were reviewed at a tertiary cancer hospital. The surgical records were blinded to the radiologists. A radiologic classification into 3 types (I, II, and III) based on the maximum degree of circumferential contact of the tumor with the internal carotid artery (ICA) was attempted and correlated with the Shamblin group in surgical records. There were 5 type III, 3 type II, and 1 type I tumors. The type I tumor had an ICA maximum circumference of contact less than or equal to 180 degrees , type II tumors had more than 180 degrees and less than 270 degrees , and type III tumors had a maximum circumference of contact of 270 degrees of more. MR imaging accurately predicted the Shamblin group in 8 (100%) of 8 operated tumors. Tumor size and Shamblin group did not have a uniformly predictable relation. Shamblin group can be predicted preoperatively on MR imaging, and the maximum degree of circumferential contact of the CBT with the ICA on axial images is the criterion to predict the Shamblin group.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Ultrason
                Journal ID (iso-abbrev): J Ultrason
                Journal ID (publisher-id): JoU
                Title: Journal of Ultrasonography
                Publisher: Exeley Inc.
                ISSN (Print): 2084-8404
                ISSN (Electronic): 2451-070X
                Publication date (Print): November 2020
                Publication date (Electronic): 28 September 2020
                Volume: 20
                Issue: 82
                Pages: e218-e221
                Affiliations
                [1 ]Department of Oral Surgery, Implant Surgery and Radiology, Faculty of Dentistry, Aristotle University of Thessaloniki , Greece
                [2 ]Department of Radiology, AHEPA General Hospital , Thessaloniki, Greece
                [3 ]Faculty of Dentistry, Department of Dentomaxillofacial Radiology , Ankara, Turkey
                Author notes
                Correspondence: Dr. Kaan Orhan, Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Besevler, Ankara Turkey 06500; tel.: 00 90 (535) 6765010, fax: 00 90 (312) 2123954, e-mail: call53@ 123456yahoo.com
                Article
                Publisher ID: exeley
                DOI: 10.15557/JoU.2020.0037
                PMC ID: 7705482
                SO-VID: 50e3f618-f67c-4bd3-8b18-23a9ed826c6c
                Copyright © © Polish Ultrasound Society
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial NoDerivatives License (CC BY-NC-ND). Reproduction is permitted for personal, educational, non-commercial use, provided that the original article is in whole, unmodified, and properly cited.

                History
                Date received : 09 April 2020
                Date accepted : 05 July 2020
                Categories
                Subject: Medicine

                Keywords: glomus tumor,paraganglioma,doppler ultrasonography,common carotid artery
                Data availability:
                Keywords: glomus tumor, paraganglioma, doppler ultrasonography, common carotid artery

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