Author(s)
Ameer T. Shah, MD
Andrew P. Katz, BS
Mark D. Iafrati, MD
Richard O. Wein, MD
Affiliation(s)
Tufts Medical Center
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the common presentations of amyloidosis in the head and neck. They will also be able to review an interesting case of amyloidosis of the carotid body, which is an uncommon pathologic finding in carotid body tumors. They will also be able to review preoperative imaging workup for carotid body tumors and appreciate the interdisciplinary approach when surgery does not go as planned, specifically in reference to the management of intracarotid artery injury. Objectives: Review the literature of both masses of the carotid body and the presentation of head and neck amyloidosis. The preoperative workup, intraoperative decision making, histologic diagnosis, and postoperative care and additional workup will be presented and discussed. Study Design: Case presentation and literature review. Methods: The preoperative imaging and workup is presented, followed by intraoperative findings and postoperative course and histology. Results: The patient had a complicated intraoperative course, due to injury to the carotid artery, that required the assistance of vascular surgery. Postoperatively the patient experienced an expanding hematoma in the intensive care unit that required exploration. Histology later returned with an unexpected diagnosis of amyloidosis. Conclusions: Amyloidosis can present in the head and neck, however the carotid body is an extremely rare and unexpected location. This case was interesting with respect to the workup, intraoperative and immediate postoperative complications. The histologic findings were also interesting and invoked a multidisciplinary approach to the patient's care.