術前のIvalon^<(R)>塞栓術が有効であったcarotid body tumorの全摘例

概要

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Surgery for carotid body tumors has been said to have many difficulties. In this paper a case of a big carotid body tumor managed with preoperative catheter embolization is reported. A 22-year-old male was referred in May, 1983, complaining of a right neck mass measuring 6 × 4 cm, of two years duration. Before admission he had been operated on twice in another hospital, but removal of the tumor had been impossible because of excessive bleeding. Angiography revealed a highly vascular tumor at the carotid bifurcation, fed by branches of the external carotid artery, namely the superior thyroid, lingual, occipital, and ascending pharyngeal arteries. Selective catheter embolization of these feeders was performed using Ivalon^<(R)> powder, and during this procedure temporary occlusion of the internal carotid artery with a balloon catheter was employed in an attempt to avoid cerebral emboli. After the embolization the tumor stain disappeared almost entirely, and the size of the tumor was reduced. In the operation the tumor was easily excised without giving any injuries to the surrounding nerves or the carotid arteries. The total bleeding volume was less than 250 cc and blood transfusion was not necessary. Preoperative catheter embolization for carotid tumors is advisable, especially for a big tumor.
日本脳神経外科学会の論文
1985-12-15