左上颈无痛性肿物明显增大

Successful Removal of a Malignant Carotid Body Tumor in the Left Side of the Upper Neck

患者左上颈肿物6年,近1年增大明显,无其他不适。MRI检查发现肿物生长包绕颈动脉,CT检查显示肺部多个结节,诊断为恶性颈动脉体瘤。在行颈动脉压迫锻炼后,实施肿瘤连同颈动脉切除,并重建颈动脉,患者恢复顺利。讨论认为恶性颈动脉体瘤的诊断应以生物学行为是否有侵犯和转移为准,而非依组织学表现诊断。术后PET-CT证实肺部为转移瘤,病理诊断有淋巴结转移。病例较罕见,对此类病例的手术及后续治疗应总结经验教训。

A 53 year-old man presented with a 6-year history of a mass in the left side of his upper neck that had been increasing in size for the past year. A MRI scan showed a mass intimately surrounding the carotid body and CT showed multiple nodules in the lungs, so he was diagnosed with malignant carotid body tumor. After compression of the carotid body, the surgeons removed the tumor and the left carotid artery and then rebuilt the carotid body. The patient recovered well after surgery. The doctors agreed that the diagnosis of malignant carotid body tumor did not depend on the histology alone but on biological behaviors, namely invasion or metastasis. A PET-CT scan verified metastatic tumors in the lungs, and metastatic lymph nodes were also found histologically. This type of malignancy is exceedingly rare, so the doctors involved deemed it advantageous to share the surgical method and post- operative treatments.