Dharamshila Hospital and Research Centre Removes Rare-sized Carotid Body Tumour
Tumour was highly vascular and being supplied by branches
of common carotid, internal carotid and external carotid artery
Dr Anshuman Kumar with the patient
Dharamshila Hospital and Research Centre, Delhi gave a new
lease of life to 52-year-old lady from Kabul, Afghanistan suffering from carotid
"This lady had visited nearly all the hospitals there
to get this tumour removed, but no one was ready to take it up. We decided to
take this challenge. The whole operation was as challenging as diffusing an
atom bomb," says Dr Anshuman Kumar, Consultant Onco-surgeon, Dharamshila
Hospital and Research Centre, who conducted this surgery.
Swelling in the neck is not uncommon. There are many more reasons for this stage-
from tuberculosis to tumour. When an unusual tumour presents with difficulty
in breathing and swallowing, the situation is even worse. This was, however,
the rare case with this lady presenting with long history of neck swelling on
the right side and recent development of difficulty in breathing and swallowing
due to pressure on the upper part of wind and food pipe.
After complete investigation, it was labelled as carotid body tumour arising
from the carotid arteries in the neck. This surgery was difficult to conduct
because two carotid arteries (one on each side of the neck) supply blood to
the large, front part of the brain, where thinking, speech, personality and
sensory and motor functions reside. Carotid body is an organ at the bifurcation
of the common carotid artery and is responsible for maintenance of pulse, blood
pressure and respiration through feedback mechanism.
"During surgery, there is always a risk of bradycardia, and hypotension.
Tumour was highly vascular and being supplied by branches of common carotid,
internal carotid and external carotid artery, therefore, there were high chances
of bleeding. During surgery injury to the internal carotid artery may lead to
hemiplegia (loss of power in one half of body) and even death," informs
Other vital structures like proximity of the tumour to cranial nerves and the
vulnerability to injury were saved in the case. In this particular case, the
tumour was very big (Shamblin type III) and encroached upon the parapharyngeal
space and skull base, again an area of meticulous and delicate approach during
First of all, vital structures are taken care of -- major blood vessels and
all cranial nerves in the viscidity of tumour. "Bipolar cautery was used.
It minimises the risk of carotid body stimulation," says Dr Kumar. Meticulous
dissection in the subadventitial plane of the carotid vessels took the surgery
forward. "Finally, dissection at the skull base and parapharyngeal space
was done to remove the tumour," concluded Dr Kumar.
During the operation, there was constant monitoring and maintenance of vital
parameters. Post operatively, patient recovered uneventfully and was discharged
on the third post-operative day. As of today, she has recovered and is back