Carotid body tumors

A retrospective study of 20 patients treated at the Tata Memorial Hospital over a period of 50 years, 1941-1991, is presented. Seventy-five percent (15/20) of the patients presented before their fifth decade with a male-to-female ratio of 2:1. The commonest presenting symptom was a painless lump in the neck. Twenty-five percent (5/20) had an incisional biopsy done elsewhere prior to referral to our institute. We performed a subadventitial excision of the tumor in 17 patients, 3 of whom were given postoperative radiation therapy. Three patients underwent complete excision of the carotid system without a vascular replacement, one of whom developed hemiparesis secondary to a cerebral infarct. There was no operative/postoperative mortality. Cranial nerve palsy was seen in 45% (9/20) of patients; the hypoglossal nerve was most commonly affected. One patient had a recurrence, 6 years after surgery, whereas 60% of patients operated on before 1987 have completed a 5-year disease free survival. Forty percent of patients have yet to have a 5-year follow-up period. Reports of newer diagnostic and therapeutic modalities are discussed.