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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors discuss the epidemiology, histology, symptomatology, diagnosis and therapy of carotid body tumors, basing their discussion on three personal observations and on a case of cervical dermatocyst which showed clinical and radiological data consistent with diagnosis of a glomus tumor. Chemodectomas of the neck are more often seen in the carotid body and are considered histologically benign, although they might induce local or distant metastases. Clinical presentation is often non-specific and may only consist in a slowly growing mass in the higher jugular-carotid region. Among the various imaging techniques (CT, MR), supra-aortic selective angiography, including digital subtraction techniques, is now considered the most reliable tool, while ultrasonography and gammagraphy with 99mTc-gluconate or 131I-MBG are recommended for screening and family testing purposes. Biopsy is to be avoided as it is very likely to cause massive bleeding and because of the high percentage of false negatives. Surgery is the choice treatment, and lateral cervicotomy is the recommended approach for exeresis of the mass, while radiotherapy should be planned in patients with precise contra-indications for surgery and when the tumor mass has already reached the skull base. Pre-operatory selective embolization is still controversial.
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PMID:[Carotid body tumors: the clinical, diagnostic and therapeutic aspects]. 130 44

Twenty-six patients with chemodectomas were treated with radiation therapy from 1961 to 1983 and followed for at least 4 years. In 16 glomus tympanicum lesions treated primarily with radiation, long-term control was achieved in all (follow-up 4-24 years, mean 10.5). Fifteen of 16 had no clinical evidence of disease at time of death or last follow-up, and one patient had recurrent but stable disease at 10 years and died of an unrelated illness 19 years after treatment. Eight of the glomus tympanicum lesions were referred for radiation therapy with persistent disease after multiple surgical procedures. Two had extensive skull and intracranial involvement at the time of radiation. Six patients with glomus jugulare lesions were treated with radiation. Four achieved long-term control, and two died of their disease. In addition, two glomus vagal and one carotid body tumor were treated with palliative intent. One glomus tympanicum lesion was treated with preoperative radiation and resection. Chemodectoma was the cause of death in 4 of 25 patients--3 from intracranial extension and 1 from lung and mediastinal metastases. All four patients were referred for radiation with metastases or extensive bone involvement at the skull base. Radiation appears to be effective in achieving long-term clinical control of chemodectomas. Adequately treated volume should be determined with arteriography and/or contrast-enhanced computer tomography, allowing for geometric margins. Doses in the range of 4,500 to 5,000 cGy delivered in about 5 weeks are recommended.
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PMID:Radiation therapy in the treatment of chemodectomas. 282 34

Magnetic resonance imaging (MRI) features in a case of malignant glomus jugulare tumour are reported. Chemodectomas are benign in 95 per cent of cases and malignant in five per cent. Only one case report of CT findings in this unusual CP angle tumour with pulmonary metastases has been cited in the literature. It is concluded that MRI can provide useful information about the nature of chemodectomas although it cannot distinguish between benign and malignant tumours, except when regional lymph nodes are involved or when distant metastases exist.
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PMID:MRI features in a malignant glomus jugulare tumour. 828 87