Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2346-2351
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2346
Large carotid body tumor successfully resected in hybrid operating theatre: A case report
Meng-Qi Li, Yan Zhao, Huai-Yu Sun, Xin-Yu Yang
Meng-Qi Li, Yan Zhao, Xin-Yu Yang, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Huai-Yu Sun, Department of Neurosurgery, TieMei General Hospital of Liaoning Health Company Affiliated Shenyang Medical College, Tieling 112000, Liaoning Province, China
Author contributions: Li MQ and Zhao Y contributed equally to this article; Yang XY and Zhao Y were the patient’s neurosurgeons; Li MQ reviewed the literature and contributed to manuscript drafting; Sun HY drew the diagram and reviewed the literature; Zhao Y interpreted the imaging findings; Yang XY was responsible for the revision of the manuscript for important intellectual; all authors issued final approval for the version to be submitted.
Supported by the National Natural Science Foundation of China, No. 81571144; and the Natural Science Foundation of Tianjin City, No. 16JCZDJC35700.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Yu Yang, MD, PhD, Professor, Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Tianjin 300052, China. yangxinyu@tmu.edu.cn
Telephone: +86-186-22766038 Fax: +86-22-60362237
Received: January 27, 2019
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
Abstract
BACKGROUND

Surgical treatment for large carotid body tumor (CBT), particularly the Shamblin III type, is challenging and rarely reported.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Carotid body tumor, Paraganglioma, Hybrid operating theatre, Interventional embolization, Case report

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.