P.095 Role of selective neck dissections in the management of carotid body tumours

G Francis, GE Pickett, S Taylor
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Abstract

Background: Carotid body tumours (CBT) are rare neoplasms of the paraganglia at the carotid bifurcation. Histopathologic analysis alone is insufficient to confirm malignancy, requiring metastases to non-neuroendocrine tissue including cervical lymph nodes for definitive diagnosis. The role of selective neck dissection (SND) during CBT surgeries in detecting malignancy and guiding subsequent management remains uncertain. Methods: A retrospective case series was performed on all patients undergoing CBT surgeries with SND between 2002 and 2022. Data collection included demographics, genetic and laboratory testing, imaging, intra- and post-operative complications, follow-up and histopathology. Results: Twenty-one patients underwent CBT resection with SND. Of these, 3 had carotid artery injuries, and 5 had nerve injuries. One patient experienced peri-operative embolic strokes, presumed related to tumour embolization. Three patients were found to have lymph node involvement, confirming malignancy. Malignancy was significantly associated with the risk of carotid injury (p = 0.04.) Conclusions: SND is a useful adjunct in detecting malignancy during CBT resection. The incidence of malignancy in CBT is low but not negligible and SND should be considered in patients with suspected malignancy or high-risk factors. This study’s 14% incidence of malignancy suggests there may be a rationale for considering universal implementation of SND during CBT resection.
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P.095 颈部选择性切除术在颈动脉体肿瘤治疗中的作用
背景:颈动脉体瘤(CBT)是颈动脉分叉处副神经节的罕见肿瘤。仅靠组织病理学分析不足以确诊恶性肿瘤,需要非神经内分泌组织(包括颈淋巴结)的转移才能明确诊断。CBT 手术中的选择性颈部切除术(SND)在发现恶性肿瘤和指导后续治疗方面的作用仍不确定。方法:对 2002 年至 2022 年期间接受 CBT 手术并行 SND 的所有患者进行了回顾性病例系列研究。收集的数据包括人口统计学、基因和实验室检测、影像学、术中和术后并发症、随访和组织病理学。结果21名患者接受了CBT和SND切除术。其中,3例颈动脉损伤,5例神经损伤。一名患者在围手术期出现栓塞性中风,推测与肿瘤栓塞有关。三名患者被发现淋巴结受累,证实为恶性肿瘤。恶性肿瘤与颈动脉损伤的风险明显相关(p = 0.04):SND 是 CBT 切除术中检测恶性肿瘤的有效辅助手段。CBT 中恶性肿瘤的发生率很低,但也不容忽视,对于疑似恶性肿瘤或有高危因素的患者,应考虑使用 SND。本研究中恶性肿瘤的发生率为 14%,这表明在 CBT 切除术中考虑普及 SND 是有道理的。
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