Retropharyngeal carotid body tumor: A challenge in terms of surgical technicality

Carotid body tumors are rare neoplasms originating from neural crest cells, commonly presenting as a painless, slow-growing mass in the lateral neck. The retropharyngeal variant of these tumors is particularly uncommon, with an incidence of approximately 2.6 %.

A 50-year-old man presented to the Otolaryngology Department at Rasoul Akram Hospital with a painless 3 × 4 cm mass on the right side of his neck, which had gradually increased in size. Clinical examination revealed a pulsatile, nontender mass exerting pressure on the right lateral aspect of the pharynx. A CT scan showed a well-defined, enhancing retropharyngeal mass located between the internal and external carotid arteries on the right side, suggestive of a carotid body tumor. The patient underwent surgical resection, achieving complete tumor removal without complications. A four-year follow-up revealed no signs of tumor recurrence.

Carotid body tumors are indolent masses. Diagnosis typically involves clinical evaluation, supplemented by imaging techniques such as ultrasound, CT scan, and MRI, which aid in delineating the tumor's morphology and dimensions. Surgical resection remains the preferred treatment, aiming to achieve complete tumor excision while preserving blood flow, avoiding damage to critical organs and nerves, and safeguarding brain function.

The retropharyngeal location of carotid body tumors represents an exceptionally rare variant, and their surgical resection presents a significant challenge for surgeons. This case report offers crucial insights into the surgical management of a retropharyngeal carotid body tumor, serving as a valuable resource for future surgeons who may face similar cases.