Documente Academic
Documente Profesional
Documente Cultură
Glomus
Carotdeo
Dr. Wagner Romero
R3 Cirugia General
Universidad Central del Ecuador
Hospital de Especialidades
Eugenio Espejo
Mide 3 x 6 mm
Peso: 2mg
Guild, SR. A hitherto unrecognized structure, the glomus jugularis. Man. Anat. Rec. (Suppl. 2), 79: 28, 1941.
Mulligan, RM. Chemodectoma in the Dog. Am. J. Path. 1950. 26: 680.
Lattes, R. Nonchromaffin paraganglioma of ganglion nodosum, carotid body, and aortic-arch bodies. Cancer,
1950; 3: 667.
Epidemiologia
Paragangliomas
0,8/100.000/ao
30 50 aos
H:M
Benignos
Tumor del Glomus: 65% de todos los
paragangliomas de cabeza y cuello
10%
Malignidad
10% Bilaterales
10% antecedente familiar
Derrick Lin, MD; Sally E Carty, MD, FACS; William F Young, Jr, MD, Msc
Paragangliomas: Epidemiology, Clinical Presentation, Diagnosis, And Histology. Uptodate, Sept 9 th 2013
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Factores de Riesgo
Sindromes
hereditarios
Derrick Lin, MD; Sally E Carty, MD, FACS; William F Young, Jr, MD, MSc
Paragangliomas: Epidemiology, clinical presentation, diagnosis, and histology. UpToDate, Sept 9 th 2013
Factores de Riesgo
Asociacin
hipoxia paraganglioma
Grandes alturas
Prevalencia:
bovinos
86 a 96% en mujeres
EPOC
High altitude hypoxia and chemodectomas. Saldana MJ, Salem LE, Travezan R. Hum
Pathol. 1973 Jun;4(2):251-63
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Patologa
Crecimiento
lento
Vascularizados
Benignos
Histologa: Pequeos nidos de clulas
cromafnicas poligonales uniformes
(Zellballen")
Inmunohistoquimica: S-100 positivos
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Patologa
Criterios
de malignidad
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
CLASIFICACION
Clasificacion
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Cuadro Clnico
Hallazgo casual
Al examen fsico
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Diagnostico
TC
RMN
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Tratamiento
Seleccin
de pacientes
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Manejo no Quirurgico
Observacin
rpida de sntomas
Crecimiento del tumor desproporcionado
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Radioterapia
No
erradica el tumor
Tecnica convencional
Radiociruga estereotctica
Radiociruga con bistur gamma
Indicaciones
Ancianos
Shamblin III > 5cm
Mal estado general
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Mohamad Chaaban, MD; Chief Editor: Arlen D Meyers, MD, MBA. Carotid Body Tumors
Treatment & Management. Jan 14, 2014
Embolizacion
Indicado
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Mohamad Chaaban, MD; Chief Editor: Arlen D Meyers, MD, MBA. Carotid Body Tumors
Treatment & Management. Jan 14, 2014
Tratramiento Mdico
Util
en paragangiomas funcionantes
Inhibidores del anlogo de la
somatostatina
No
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Tratamiento Quirrgico
Indicaciones
confirmada
Crecimiento rpido
Compresin local
joven
Lesin unilateral
Riesgo minimo de lesin neurolgica
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Preparacion Prequirrgica
Si la lesin es grande y muy vascularizada se
debe realizar angiografa
Embolizacin preoperatoria: 24 horas
previos a la ciruga
Estimar el potencial sangrado transquirurgico
En tumores grandes: estudios de oclusion
para demostrar buena circulacin del flujo
carotideo contralateral
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
general
Electrocauterio bipolar
Instrumental vascular (clamps, loops,
Fogarty)
Posicion: decubito supino, cuello
extendido y lateralizado en sentido
contralateral
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14
Complicaciones
Lesin
Mohamad Chaaban, MD; Chief Editor: Arlen D Meyers, MD, MBA. Carotid Body
Tumors Treatment & Management. Jan 14, 2014
Cuidado Postoperatorio
Supervision
de neuropatias craneales
Evaluar habla y deglucion
En caso de lesiones permanentes:
Jatin Shahs. Head And Neck. Surgery And Oncology. Fourth Edition (2012) Chapter 14