A role for ipsilateral, selective neck dissection in carotid body tumours

A reliable diagnosis of malignant carotid body tumour can only be made in the presence of metastatic disease, because the histological features of the primary tumour do not correlate with clinical behaviour.

We report two cases of malignant carotid body tumour in which regional nodal biopsy at the time of excision of the primary tumour revealed unsuspected metastatic disease.

Reoperation in the neck for recurrent metastatic carotid body tumour is difficult and potentially hazardous. The presence of occult metastatic disease is easily identified if a selective - or sentinel - nodal dissection is performed routinely in cases of carotid body tumour excision. Such an approach adds very little morbidity, effort or time to the primary surgery, and is recommended. This view has been supported by some other authors but is generally overlooked in clinical practice.