Arterial catheter embolization followed by surgery for large chemodectoma

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Head and Neck Oncology

Background:

• Chemodectomas, rare neuroendocrine tumors, can present as large neck masses.
• Management of large chemodectomas poses challenges due to vascularity and potential complications.
• Previous refusal of therapy by the patient necessitated a novel treatment approach.

Observation:

• A 21-year-old male presented with a large, symptomatic right neck chemodectoma diagnosed five years prior.
• The patient experienced increasing difficulty with swallowing due to the tumor's size.
• Preoperative embolization was chosen to manage the tumor's extensive vascular supply.

Findings:

• Selective arterial catheter embolization of the occipital and posterior auricular arteries and thyrocervical trunk was performed using Ivalon sponge.
• Postembolization arteriography demonstrated 90% occlusion of tumor vascularity.
• A 30% reduction in tumor size was observed following embolization, facilitating subsequent surgical removal.

Implications:

• Preoperative arterial embolization is a viable and effective strategy for managing large neck chemodectomas.
• The combined embolization and surgical resection approach offers a promising minimally invasive option for complex head and neck tumors.
• This technique may improve surgical outcomes and reduce operative morbidity in similar cases.