Literature DB >> 23433498

Paraganglioma of the carotid body: treatment strategy and SDH-gene mutations.

J Fruhmann1, J B Geigl, P Konstantiniuk, T U Cohnert.   

Abstract

OBJECTIVES: The aim of the present study was to review treatment results in patients with paraganglioma (PGL) of the neck presenting as carotid body tumour, long-term follow-up and relevance of genetic testing for succinate dehydrogenase (SDH)-gene mutations.
DESIGN: Retrospective analysis of prospectively collected data and prospective genetic analysis.
MATERIALS AND METHODS: Over a 25-year period (1987-2011) 50 patients were operated for 63 PGLs of the neck. Pre-, intra- and postoperative findings were analysed. Sanger sequencing was performed for genetic testing of SDH-gene mutations (SDH B, SDHC and SDHD).
RESULTS: Fifty patients underwent resection of 63 PGLs (62 benign, one malignant) without mortality. Eight patients underwent preoperative embolisation. Vascular surgical procedures were required in 15 operations (15/63 = 23.8%). Nerve lesions occurred after 13 operations (13/63 = 20.6%) and were associated with large tumours. A total of 44 patients are alive after a mean follow-up of 9.8 years. In 40 patients 17 SDH-gene mutations were detected (17/40 = 42.5%): 14 SDHD mutations, two SDHB mutations and one rare SDHC mutation.
CONCLUSION: Surgery for PGL is recommended. All PGL patients should be screened for SDH mutations because it impacts the individual follow-up strategy. Whereas all PGL patients require annual ultrasound control, mutation carriers and family members with proven mutations should in addition be regularly examined by magnetic resonance imaging (MRI) of head, neck, thorax, abdomen and pelvis.
Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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Year:  2013        PMID: 23433498     DOI: 10.1016/j.ejvs.2013.01.018

Source DB:  PubMed          Journal:  Eur J Vasc Endovasc Surg        ISSN: 1078-5884            Impact factor:   7.069


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