Carotid body tumor secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Maria Fernanda Villarreal, M.D. [3]
Overview
There is insufficient evidence to recommend routine screening for the carotid body tumor. However, patients who manifested the symptoms before the age of 50 years old, those with a positive family history and those with multiple paragangliomas has been recommended to undergo additional testing.
Screening
- There is insufficient evidence to recommend routine screening for the carotid body tumor. However, it has been recommended that the following patients should undergo additional evaluations:[1]
- Patients younger than 50 years of age
- Patients with a positive family history for paraganglioma
- Patients with multiple paragangliomas
Patient with carotid body tumor | |||||||||||||||||||||||||||||||||||
History, Physical examination, and evaluation of cnotralateral side | |||||||||||||||||||||||||||||||||||
Patients with age < 50 years Patients with multiple paraganglioma Patients with a positive family history | The rest of the patients | ||||||||||||||||||||||||||||||||||
SDHD genetic testing | |||||||||||||||||||||||||||||||||||
Presence of SDHD mutation | Absence of SDHD mutation | ||||||||||||||||||||||||||||||||||
SDHC and SDHB genetic testing | |||||||||||||||||||||||||||||||||||
Presence of SDHC/SDHB mutation | Absence of SDHC/SDHB mutation | ||||||||||||||||||||||||||||||||||
All the relatives should be evaluated for the presence of paragnaglioma | |||||||||||||||||||||||||||||||||||
whole-body F-dihydroxyphenylalanine (F-DOPA) positron emission tomography to assess the presence of other paragangliomas | |||||||||||||||||||||||||||||||||||
Presence of other paraganglioma | Absence of other paraganglioma | ||||||||||||||||||||||||||||||||||
24-hour urine catecholamines and MRI for biochemical screening | surveillance screening every 5 years | ||||||||||||||||||||||||||||||||||
- In case of functional paraganglioma, the patient should receive a-blockers, followed by b-blockers for symptom control before excision of the tumor.
References
- ↑ Davila, Victor J.; Chang, James M.; Stone, William M.; Fowl, Richard J.; Bower, Thomas C.; Hinni, Michael L.; Money, Samuel R. (2016). "Current surgical management of carotid body tumors". Journal of Vascular Surgery. 64 (6): 1703–1710. doi:10.1016/j.jvs.2016.05.076. ISSN 0741-5214.