Carotid body tumor diagnostic study of choice: Difference between revisions
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**Color Doppler ultrasound is a non-invasive investigation with relatively high sensitivity and specificity for the tumor diagnosis. | **Color Doppler ultrasound is a non-invasive investigation with relatively high sensitivity and specificity for the tumor diagnosis. | ||
***Color Doppler ultrasound has been recommended as a method of screening for the diagnosis of carotid body tumor.<ref name="WorseyLaborde1992">{{cite journal|last1=Worsey|first1=M.J.|last2=Laborde|first2=A.L.|last3=Bower|first3=T.|last4=Miller|first4=E.|last5=Kresowik|first5=T.F.|last6=Sharp|first6=W.J.|last7=Corson|first7=J.D.|title=An Evaluation of Color Duplex Scanning in the Primary Diagnosis and Management of Carotid Body Tumors|journal=Annals of Vascular Surgery|volume=6|issue=1|year=1992|pages=90–94|issn=08905096|doi=10.1007/BF02000675}}</ref> | ***Color Doppler ultrasound has been recommended as a method of screening for the diagnosis of carotid body tumor.<ref name="WorseyLaborde1992">{{cite journal|last1=Worsey|first1=M.J.|last2=Laborde|first2=A.L.|last3=Bower|first3=T.|last4=Miller|first4=E.|last5=Kresowik|first5=T.F.|last6=Sharp|first6=W.J.|last7=Corson|first7=J.D.|title=An Evaluation of Color Duplex Scanning in the Primary Diagnosis and Management of Carotid Body Tumors|journal=Annals of Vascular Surgery|volume=6|issue=1|year=1992|pages=90–94|issn=08905096|doi=10.1007/BF02000675}}</ref> | ||
***This method is useful in the diagnosis of Shamblin’s type and intralesional blood flow of the tumor before the metastasis.<ref name="JinHe2016">{{cite journal|last1=Jin|first1=Zhan-Qiang|last2=He|first2=Wen|last3=Wu|first3=Dong-Fang|last4=Lin|first4=Mei-Ying|last5=Jiang|first5=Hua-Tang|title=Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography|journal=Ultrasound in Medicine & Biology|volume=42|issue=9|year=2016|pages=2106–2113|issn=03015629|doi=10.1016/j.ultrasmedbio.2016.04.007}}</ref> | |||
*CT imaging is useful in the diagnosis of local invasion of the tumor to adjacent arteries and skull base. | |||
*CT imaging combined with color doppler ultrasound has been suggested as the optimal detection modality for the assessment and management of the tumor. | |||
*Since the tumor is highly vascular, incisional biopsy and percutaneous needle aspiration are contraindicated and it may cause complications such as:<ref name="Mirov1962">{{cite journal|last1=Mirov|first1=Andrew G.|title=Benign and Malignant Carotid Body Tumors|journal=JAMA: The Journal of the American Medical Association|volume=181|issue=1|year=1962|pages=13|issn=0098-7484|doi=10.1001/jama.1962.03050270015003}}</ref> | *Since the tumor is highly vascular, incisional biopsy and percutaneous needle aspiration are contraindicated and it may cause complications such as:<ref name="Mirov1962">{{cite journal|last1=Mirov|first1=Andrew G.|title=Benign and Malignant Carotid Body Tumors|journal=JAMA: The Journal of the American Medical Association|volume=181|issue=1|year=1962|pages=13|issn=0098-7484|doi=10.1001/jama.1962.03050270015003}}</ref> | ||
**Massive bleeding | **Massive bleeding | ||
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=== Study of choice === | === Study of choice === | ||
* | |||
*Genetic analysis should be considered for patients with:<ref name="DavilaChang2016">{{cite journal|last1=Davila|first1=Victor J.|last2=Chang|first2=James M.|last3=Stone|first3=William M.|last4=Fowl|first4=Richard J.|last5=Bower|first5=Thomas C.|last6=Hinni|first6=Michael L.|last7=Money|first7=Samuel R.|title=Current surgical management of carotid body tumors|journal=Journal of Vascular Surgery|volume=64|issue=6|year=2016|pages=1703–1710|issn=07415214|doi=10.1016/j.jvs.2016.05.076}}</ref> | *Genetic analysis should be considered for patients with:<ref name="DavilaChang2016">{{cite journal|last1=Davila|first1=Victor J.|last2=Chang|first2=James M.|last3=Stone|first3=William M.|last4=Fowl|first4=Richard J.|last5=Bower|first5=Thomas C.|last6=Hinni|first6=Michael L.|last7=Money|first7=Samuel R.|title=Current surgical management of carotid body tumors|journal=Journal of Vascular Surgery|volume=64|issue=6|year=2016|pages=1703–1710|issn=07415214|doi=10.1016/j.jvs.2016.05.076}}</ref> | ||
**A positive family history | **A positive family history | ||
Revision as of 16:05, 9 April 2019
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Carotid body tumor diagnostic study of choice On the Web |
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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]
Overview
Diagnostic Study of Choice
- The carotid body tumor is diagnosed primarily by history and physical examination.[1]
- Imaging studies are necessary to make the final diagnosis.
- Digital subtraction angiography (DSA) is the golden standard for the diagnosis of carotid body tumor.
- Color Doppler ultrasound is a non-invasive investigation with relatively high sensitivity and specificity for the tumor diagnosis.
- CT imaging is useful in the diagnosis of local invasion of the tumor to adjacent arteries and skull base.
- CT imaging combined with color doppler ultrasound has been suggested as the optimal detection modality for the assessment and management of the tumor.
- Since the tumor is highly vascular, incisional biopsy and percutaneous needle aspiration are contraindicated and it may cause complications such as:[4]
- Massive bleeding
- Pseudoaneurysm formation
- Carotid thrombosis
The comparison of various diagnostic studies for carotid body tumor
| Test | Sensitivity | Specificity | Accuracy |
|---|---|---|---|
| CT angiography | 100% | ...% | 100% |
| Color Doppler ultrasound | 89.8% | 82.6% | 87.5% |
Study of choice
- Genetic analysis should be considered for patients with:[5]
- A positive family history
- Presence of multiple paragangliomas
- Those who manifest the tumor before 50 years of age
Diagnostic results
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
- [Finding 1]
- [Finding 2]
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
- There are no established criteria for the diagnosis of carotid body tumor.
- There is no accepted histologic criteria for the diagnosis of malignancy in the carotid body tumor. To confirm malignant transformation of the tumor,
References
- ↑ Luo T, Zhang C, Ning YC, Gu YQ, Li JX, Wang ZG (March 2013). "Surgical treatment of carotid body tumor: case report and literature review". J Geriatr Cardiol. 10 (1): 116–8. doi:10.3969/j.issn.1671-5411.2013.01.018. PMC 3627704. PMID 23610583.
- ↑ Worsey, M.J.; Laborde, A.L.; Bower, T.; Miller, E.; Kresowik, T.F.; Sharp, W.J.; Corson, J.D. (1992). "An Evaluation of Color Duplex Scanning in the Primary Diagnosis and Management of Carotid Body Tumors". Annals of Vascular Surgery. 6 (1): 90–94. doi:10.1007/BF02000675. ISSN 0890-5096.
- ↑ Jin, Zhan-Qiang; He, Wen; Wu, Dong-Fang; Lin, Mei-Ying; Jiang, Hua-Tang (2016). "Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography". Ultrasound in Medicine & Biology. 42 (9): 2106–2113. doi:10.1016/j.ultrasmedbio.2016.04.007. ISSN 0301-5629.
- ↑ Mirov, Andrew G. (1962). "Benign and Malignant Carotid Body Tumors". JAMA: The Journal of the American Medical Association. 181 (1): 13. doi:10.1001/jama.1962.03050270015003. ISSN 0098-7484.
- ↑ 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.