Background: Carotid body tumors (paragangliomas of the carotid body) are rare, highly vascularized, slow-growing neoplasms, representing the most common head and neck paraganglioma. Surgical management depends on the Shamblin classification, with type I tumors associated with the lowest complexity and risk. Objective: To report a case of Shamblin type I carotid body tumor successfully managed surgically with favorable outcomes. Case Presentation: A 52-year-old woman presented with a painless, pulsatile left lateral neck mass of one-year duration following an upper respiratory infection, positive Fontaine sign, and no compressive symptoms. Doppler ultrasound and CT angiography confirmed a well-defined, highly vascular lesion <4 cm at the left carotid bifurcation, classified as Shamblin type I. Complete resection was performed via subadventitial dissection under general anesthesia, preserving cranial nerves IX, X, and the posterior auricular branch, with LigaSure®-assisted vascular sealing. Operative time was 4 hours, with 300 cc estimated blood loss and no intraoperative complications or need for vascular reconstruction. Results: Macroscopically, the specimen was a firm, well-encapsulated brown mass. Microscopically, it showed classic paraganglioma features: Zellballen pattern with nests of chief (type I) and sustentacular (type II) cells separated by thin fibrovascular septa, and prominent hypervascularity, confirming the diagnosis. Conclusion: Early surgical resection in Shamblin type I carotid body tumors yields excellent results with minimal morbidity, neurovascular preservation, and low blood loss. This case supports surgery as the treatment of choice for early-stage lesions, with long-term follow-up recommended to monitor for rare recurrence.
Esmenjaud et al. (Thu,) studied this question.