R carotid body tumor

Summary:

A discussion on primary management.

R carotid body tumor

Indranil Mallick 10 Jan 2010 20:31

Patient demographics

45/Female

History

R upper neck mass - slowly growing x 6 months. Non-smoker. No medical comorbidities. No other symptoms.

Treatment details

No treatment received or biopsy done

Clinical Features

3.5 cm R level II mass - relatively mobile, well encapsulated. No mucosal abnormalities.

Tests

CT + MRI done in the last 3 weeks - demonstrates an encapsulated lesion consistent with a pragnaglioma - a carotid body tumor. No lymphadenopathy. No other abnormalities.

Final Diagnostic summary

Relatively asymptomatic R carotid body tumor 3.5 cm in size.

Issue(s) for discussion

• Primary management - surgery vs. RT.
• Role of RT in general.
• Dose volumes for RT if used as primary treatmet.

Your tentative plan

I was thinking of referring this patient to an experienced surgeon in my hospital.

Site group inclusion requested

Not required.

Re: R carotid body tumor

Indranil Mallick 10 Jan 2010 20:39

1. Primary management should be surgery if possible. Take an opinion from an experienced surgeon. Usually patients may be followed after surgery with regular clinical examination and imaging. RT is usually reserved for relapse. There is no urgency to treat if lesion is relatively asymptomatic. Regular imaging to follow lesion - treat when unequivocally increasing or symptomatic.
2. RT is a reasonable and established option for stabilizing the tumor. May not shrink volume but lesions are usually well-controlled for years. Usually attempted if sufery is not feasible.
3. A dose of 45Gy/25Fr or any other standard dose for benign lesions is appropriate. Volumes should be limited to primary disease only with limited margins.

Re: R carotid body tumor

Nikhilesh Patil 14 Jan 2010 21:39

I agree