Arterial catheter embolization followed by surgery for large chemodectoma

We report on the first successful preoperative arterial catheter embolization of a large neck chemodectoma followed by its surgical removal. A 21-year-old man presented with a large mass in the right neck diagnosed 5 years previously by biopsy as a chemodectoma. The patient previously had refused therapy. Because of concern over the large size of the mass and increasing difficulty in swallowing, he agreed to undergo therapy. The patient underwent selective occlusion of the occipital and posterior auricular arteries and the thyrocervical trunk using Ivalon sponge emboli injected through a No. 5 Fr Hanafee catheter. A postembolization arteriogram showed 90% occlusion of tumor vascularity and 30% decrease in size of the tumor. This was followed by removal of the tumor surgically. A review of the difficult management of the patient is presented, and implications for future use of the combined procedures are discussed.