Carotid Body Tumour a Challenging Management: Rare Case Report in Baghdad Radiation Oncology Center, Medical City, Baghdad, Iraq

Abstract

Background: Paragangliomas are rare asymptomatic painless tumours, originating from paraganglionic bodies of autonomous nerve system. The carotid body tumours are the relatively rare tumour but constitute a majority of head and neck paragangliomas about 70%. These tumours are benign but possess aggressive local growth potential. The Aim of the Study: The purpose of this case report article is to introduce the challenging we exposed to it during management such cases in our country despite lack many conditions, facilities and circumstances found in other parts of the world for treatment of CBT, which is the first time study in Iraq. Case Presentation: We reported a case of the 27-year-old female patient with a left neck swelling that had persisted for 5 years. She was first diagnosed and treated surgically by local excision in 2012. Histopathology revealed the histology of carotid body tumour. She has complained of hypertension, headache, and palpitation. She was observed the gradual onset of growing and pulsating lump on previous surgical scar site. Five years later, the lesion became larger, and she feeling pulsation on lying on left side resulting in discomfort on sleep and deglutition. On physical examination, a pulsating firm painless mass measuring about 6 x 5 x 4 cm in size was found on the left side of her neck. Pulsations were felt on deep palpation and a faint bruit was heard on auscultation. Work up done for her included laboratory tests, neck US, neck CT scan, carotid angiography and slide review of histopathology. All suggested recurrent carotid body tumour. Conclusion: Over forty years of working in this field, we have only seen 3 cases of CBTs, so it is a very rare tumour. Management of this tumour is a challenging whether it is treated by surgery or radiotherapy. The main step in management is by excluding others tumours can be found in this region. Surgery is a treatment of choice while radiotherapy is standard treatment for recurrent cases.