Malignant carotid body tumors: What we know, what we do, and what we need to achieve. A systematic review of the literature.
Cesare PiazzaDavide LanciniMichele TomasoniMark ZafereoVander Poorten VincentEhab HannaAntti Aarni MäkitieVeronica Fernandez-AlvarezLuiz P KowalskiCarlos-Miguel Chiesa-EstombaAlfio FerlitoPublished in: Head & neck (2024)
Malignant carotid body tumors (MCBT) are rare and diagnosed after detection of nodal or distant metastases. This systematic review (SR) focuses on MCBT initially approached by surgery. Preferred Reporting Items for SR and Meta-Analysis (MA) guided the articles search from 2000 to 2023 on PubMed, Scopus, and Web of Science. Among 3548 papers, 132 (337 patients) were considered for SR; of these, 20 (158 patients) for MA. Malignancy rate was 7.3%, succinate dehydrogenase (SDH) mutation 17%, age at diagnosis between 4th and 6th decades, with a higher prevalence of females. MCBTs were mostly Shamblin III, with nodal and distant metastasis in 79.7% and 44.7%, respectively. Malignancy should be suspected if CBT >4 cm, Shamblin III, painful or otherwise symptomatic, at the extremes of age, bilateral, with multifocal disease, and SDHx mutations. Levels II-III clearance should be performed to exclude nodal metastases and adjuvant treatments considered on a case-by-case basis.
Keyphrases
- systematic review
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- neoadjuvant chemotherapy
- public health
- minimally invasive
- emergency department
- randomized controlled trial
- risk factors
- acute coronary syndrome
- radiation therapy
- pulmonary embolism
- coronary artery disease
- patient reported
- rectal cancer
- coronary artery bypass
- patient reported outcomes