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Jornal Vascular Brasileiro

Print version ISSN 1677-5449On-line version ISSN 1677-7301


AMATO, Alexandre Campos Moraes et al. Hybrid surgery in excision of a Shamblin II glomus tumor. J. vasc. bras. [online]. 2019, vol.18, e20180122.  Epub Feb 21, 2019. ISSN 1677-5449.

Glomus tumors are rare benign neoplasms originating from paraganglionic cells of the neural crest developing in the adventitious layer of the vessel. They are nonencapsulated and highly vascularized. A 64-year-old female patient was identified with a hypervascularized glomus tumor measuring 5 cm, posterior to the left carotid bifurcation and contralateral carotid occlusion. We performed preoperative embolization via endovascular access followed by direct percutaneous puncture, guided by angiography, to fill the remaining area. After embolization, surgical excision of the tumor was performed with reduced bleeding and it was easier to find the cleavage planes to adjacent structures. At late follow-up, the patient is free from tumor recurrence. The tumor was classified as Shamblin II, measuring 4 to 6 cm with moderate arterial insertion. Through this double approach we observed a relative reduction in intraoperative bleeding and improved identification of the cleavage plane, facilitating excision and avoiding surgical clamping.

Keywords : glomus jugulare; carotid body tumor; paraganglioma; carotid artery diseases.

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