Large carotid body tumor successfully resected in hybrid operating theatre: A case report

Figure 1 Enhanced magnetic resonance imaging. A: Coronal section (arrow indicates enhancement); B: Sagittal section (arrow); C, D: Axial section showing blood flow in the tumor (arrows). E: External carotid artery; I: Internal carotid artery.

Figure 2 Hypervascular carotid body tumor spans and remove of tumor. A: The hypervascular carotid body tumor spans from C1 to C7, and adheres to the right common carotid artery, right internal carotid artery and right external carotid artery; B: Purple: Removed tumor and external carotid artery segment; Red: Right common carotid artery and right internal carotid artery.

Figure 3 Preoperative angiography and balloon test occlusion. A: Right carotid artery angiography revealed a hypervascular tumor; B: Balloon test occlusion showed that the anterior communicating artery was open and the right internal carotid artery blood supply was compensated; C: The left vertebral artery angiography showed the posterior communicating artery was open; D: Embolization of the small feeding artery of carotid body tumor.

Figure 4 The tumor was completely removed and the right internal carotid artery flow was unobstructed. A: Intraoperative angiography showed that the internal carotid artery was unobstructed after the carotid body tumor was completely removed; B: The tumor volume decreased significantly due to blockade of blood supply; C: HE staining showed paraganglioma (× 400); D: Ultrasonography at 2 wk after the surgery (arrows: The site of surgical incision); EL 4-year follow-up.