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      Glomus Carotideo Izquierdo Translated title: Left Carotid Glomus

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          Abstract

          Resumen Los paragangliomas (cuerpo carotideo) son tumores benignos de alta vascularización ubicados en la región de los quimiorreceptores del cuerpo carotideo. Respecto a su localización, el glomus carotídeo, es del 0,01% en relación a los otros tumores de tipo paranganglioma, se observa con mayor incidencia en habitantes de lugares de altitud, más frecuente en sexo femenino. Clínicamente se presenta como una tumoración en región cervical de progresivo crecimiento, indoloro y con frémito. Dentro de los exámenes de gabinete auxiliares para diagnóstico, estan: la Ecografia Doppler, la Tomografía Axial Computarizada, la Resonancia Magnética y la Arteriografía. La técnica quirúrgica más frecuente para abordar este tumor es la disección subadventicial. Presentamos el caso clínico de una mujer de 57 años con tumor cervical, que fue intervenida quirúrgicamente, previo exámenes de laboratorio y gabinete, para la resección total del tumor y posterior estudio anatomo-patológico que reportó: paraganglioma de cuerpo carotideo.

          Translated abstract

          Abstract Paragangliomas (carotid body) are benign tumors with high vascularization located in the region of the carotid body chemoreceptors. Regarding its location, the carotid glomus is 0.01% in relation to other paranganglioma type tumors, it is observed with higher incidence in high altitude populations, more frequent in females. Clinically it presents as a tumor in the cervical region of progressive growth, painless and with fremitus. Among the auxiliary tests for diagnosis are: Doppler Ultrasound, Computerized Axial Tomography, Magnetic Resonance Imaging and Arteriography. The most frequent surgical technique to address this tumor is subadventitial dissection. We present the clinical case of a 57-year-old woman with a cervical mass, who underwent surgery, after preliminary laboratory tests, for total resection with subsequent anatomo-pathological study that reported: paraganglioma of the carotid body.

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          Tumor de cuerpo carotídeo

          Los tumores de cuerpo carotídeo (paragangliomas) son neoplasias altamente vascularizadas, muy poco frecuentes y generalmente benignas, originadas en los quimiorreceptores del cuerpo carotídeo. Se presentan los casos de dos pacientes derivados por aumento de volumen cervical izquierdo, asintomáticos, con estudio preoperatorio realizado por TAC y angiografía por TAC, respectivamente, que resultan compatibles con tumores de cuerpo carotídeo. Se resuelven quirúrgicamente, mediante disección subadventicial, informando la biopsia paraganglioma. Los tumores fueron completamente removidos, sin evidencia de recurrencia y sin mayores complicaciones.
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            Tumor de cuerpo carotídeo (paraganglioma)

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              Anesthetic approaches in carotid body tumor surgery

              OBJECTIVE: Carotid body tumors (CBT) are benign tumors that originate from neural non-chromaffin cells that are typically localized near carotid bifurcation. Surgical removal of the tumor is the most appropriate treatment. General anesthesia is preferred anesthetic technique for CBT surgery. Basic elements of anesthetic management are protection of hemodynamic stability and maintaining cerebral perfusion pressure (CPP). The aim of this study was to evaluate anesthetic management of CBT surgery and present the literature knowledge. METHODS: The study included 10 consecutive patients with diagnosis of CBT who underwent surgery at Antalya Training and Research Hospital, in Antalya, Turkey, between 2013 and 2016. Preoperative demographic details; comorbidities; side of surgical site; duration of operation; length of intensive care unit (ICU) and hospital stay; change of intraoperative blood pressure; use of inotropic drugs, blood products, and analgesics; postoperative visual analogue scale (VAS) pain score; and complications were recorded. RESULTS: According to Shamblin classification, 3 tumors were type I and the remaining 7 were type II. Tumors were located on right side in 6 patients, and on left in 4. Blood loss sufficient to require transfusion was observed in 1 patient. Average intraoperative blood loss was 287±68 mL. Tachycardia and hypertension were observed in 1 patient; bradycardia and hypotension were seen in 4 patients. Infusion for inotropic support was administered to 1 patient. Mean duration of operation was 109±20 minutes. Mean VAS score was 4±1, mean ICU tramadol consumption was 80±25 mg. Duration of stay in ICU and hospital were 2.4±1.1 hours and 3.8±0.7 days, respectively. Mortality and neurological complications were not seen in postoperative period. CONCLUSION: CBT surgery requires close and complex anesthesia management. Protection of hemodynamic stability against sudden hemodynamic changes, monitoring, and maintaining CPP are the most important aspects of anesthetic management.
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                Author and article information

                Journal
                gmb
                Gaceta Médica Boliviana
                Gac Med Bol
                Facultad de Medicina de la Universidad Mayor de San Simón (Cochabamba, , Bolivia )
                1012-2966
                2227-3662
                2022
                : 45
                : 1
                : 82-85
                Affiliations
                [1] orgnameMedico Anestesióloga
                [2] orgnameMédico Cirujano Torácico Cardiovascular
                Article
                S1012-29662022000100082 S1012-2966(22)04500100082
                10.47993/gmb.v45i1.345
                bc876079-5b12-4a8f-ace0-1bcf30f8c17e

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 05 December 2021
                : 02 May 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 4
                Product

                SciELO Bolivia

                Categories
                CASOS CLÍNICOS

                surgery,classification,diagnosis,treatment,glomus tumor,cirugía,clasificación,diagnóstico,tratamiento,tumor glómico

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