Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2346
Peer-review started: January 28, 2019
First decision: May 31, 2019
Revised: June 18, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: August 26, 2019
Surgical treatment for large carotid body tumor (CBT), particularly the Shamblin III type, is challenging and rarely reported.
In July 2014, a 63-year-old woman presented to our hospital with a large CBT (130 mm × 60 mm × 70 mm). The lesion was hypervascular, spanned from the first to the seventh cervical vertebra, and adhered to the right common carotid artery (CCA), internal carotid artery (ICA) and external carotid artery (ECA). The resection was carried out in a hybrid operating theatre. First, we used Onyx gel to embolize the feeding artery. An ICA balloon was used to prevent gel entry into the ICA. After shrinkage and hardening of the CBT, we quickly resected the CBT as well as a part of the ECA that adhered to the CBT. A vascular shunt was inserted between CCA and ICA, and the part where the ICA was cut off from the CCA was directly sutured. A follow-up at four years later showed no neurological damage.
For large hypervascular CBT, embolization of the feeding artery prior to resection is helpful. The hybrid operating theatre is the ideal platform to carry out such operations.
Core tip: Carotid body tumor of giant Shamblin III type is very rare, and the treatment for which is a big challenge for a surgeon. Combination of interventional embolization and surgical resection in the hybrid operating room is an effective method to safely and completely remove carotid body tumor lesions.