technetium-tc-99m-gluconate and Carotid-Body-Tumor

Carotid body tumours, or chemodectomas, can occur on both sides of the neck (5%), and this bilaterality increases sixfold (30%) where a familial pattern is evident. The known pathological behaviour of chemodectomas makes early recognition and management desirable, especially when an inherited predisposition can be anticipated. Difficulties in clinical diagnosis and the hazards of blind exploration have imposed a reliance on contrast angiography, which is a potentially dangerous procedure. The family tree of a patient with bilateral chemodectomas was traced and 28 individuals were studied using radionuclide angiography (99mTechnetium gluconate), a quick, safe technique with a high yield. Bilateral chemodectomas were observed in five siblings, establishing conclusively the existence of a dominant hereditary trait. Excision of newly discovered tumours was accomplished without complication. The techniques which permitted such a favourable surgical outcome are discussed, emphasising the view that these tumours are best dealt with by vascular surgeons.

Topics: Carotid Body Tumor; Gluconates; Humans; Male; Middle Aged; Neoplasms, Multiple Primary; Organometallic Compounds; Organotechnetium Compounds; Paraganglioma, Extra-Adrenal; Pedigree; Radionuclide Angiography

A technique is described for investigating tumors of the carotid body and glomus jugulare. The examination comprises an easily performed radionuclide angiogram, and has been used to investigate 30 patients. This technique demonstrated seven carotid-body tumours, including two unsuspected clinically, and one tumor of the glomus jugulare. There was also one patient with a false-positive test for bilateral carotid-body tumors. Angiographic and/or surgical confirmation was obtained in all cases but one. A significant incidence of complication during contrast angiography was noted (two cases of transient hemiparesis). The radionuclide angiogram proved safer than contrast angiography and more reliable than clinical examination; it therefore appears to be the method of choice as the primary screening test in patients with suspected carotid-body and glomus-jugulare tumors.

Topics: Angiography; Carotid Body Tumor; False Positive Reactions; Glomus Jugulare Tumor; Gluconates; Humans; Male; Middle Aged; Organotechnetium Compounds; Paraganglioma, Extra-Adrenal; Radionuclide Imaging; Technetium