Preoperative embolization of carotid chemodectoma: A technical challenge that can be customized according to angioarchitecture. Illustrative cases

Giuseppe Faragò, Carlotta Castellani, Silvano Ponzi, Claudio Jankovic, Vittorio Saginario, Carlo Berardi, Bianca Pollo, Elisa F. Ciceri

Research output: Contribution to journalArticle

Abstract

Preoperative embolization of carotid paraganglioma is increasingly used to reduce the risk of surgical bleeding obtaining a more precise and extensive tumor resection. Currently the technique can be customized in consideration of the different tumor angioarchitecture, thanks to embolic materials with different vascular penetration: solid particles of polyvinyl-alcohol (PVA), histoacryl glue, and liquid polymer (Onyx®). Two cases of swelling dissection with volume progression over time came to our observation. Both patients (45 and 70-year-old women) were studied with neck ultrasound imaging and computed tomography (CT) and/or magnetic resonance (MR). In both cases the radiological investigations confirmed the clinical suspicion of carotid paraganglioma. Both patients were sent for angiography control and preoperative devascularization of the lesion. The treatment was performed under general anesthesia using, depending on the type of tumor vasculature, in case 1 solid particles of PVA and histoacryl glue, and in case 2 Onyx® (Covidien, Irvine). The patients successfully underwent excision of the lesion via cervicotomy within a week from the embolization procedure, without any complications. The histological findings confirmed the diagnosis of chemodectoma, and macrophage infiltrates were seen in the regions previously embolized. At one-year follow-up, there was no evidence of recurrent disease. The preoperative embolization of vascular lesions of the neck represents a safe technique that yields the best results when customized over the type of vascularization of the lesion, enabling the use of the most appropriate materials, depending on the case to be treated.

Original languageEnglish
Pages (from-to)678-682
Number of pages5
JournalNeuroradiology Journal
Volume26
Issue number6
Publication statusPublished - Dec 2013

Keywords

  • Chemodectoma
  • Paraganglioma
  • Preoperative embolization

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

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