Chemodectoma of the head and neck occupies a special place in the group of paraganglionic neoplasms. Allocate chemodectoma somnolence (carotid) glomus , chemodectoma vagus nerve and atypical chemodectoma.
Chemodectomas are more often observed in women aged 20-50 years, a familial predisposition to the development of a chemodectomy , especially carotid localization , is known . The tumor has a rounded or onoid shape, its surface is smooth, the tissue is dense. Clinical manifestations depend on the location of the neoplasm. Carotid chemodectoma is localized in the area of the fork of the common carotid artery. The neoplasm is mobile in the horizontal direction, its pulsation is felt.
With large sizes, the chemodectoma spreads into the posterolateral parapharyngeal space and may clinically have pharyngeal and neurological symptoms. The vagus nerve chemodectoma is localized in the posterolateral parapharyngeal space, comes from the ganglion of the vagus nerve, always manifests pharyngeal and neurological symptoms. With large sizes, the tumor spreads to the base of the skull.
Chemodectomas of atypical localization are rare, can be localized in the supraclavicular region, on the back of the neck, affect the organs of the head and neck. Angiography and magnetic resonance imaging play a large role in the diagnosis of a chemodectic , since using these methods not only the location of the tumor is determined, but also the topic of the main vessels of the neck. Treatment is surgical (through external access with visualization of the main vessels of the neck). In inoperable conditions, radiation therapy is prescribed.
Neurosarcoma of the head and neck
Neurosarcoma of the head and neck (malignant neuroma, malignant schwannoma ) is a tumor of dense elastic consistency, with a poorly expressed capsule, often consisting of several nodes. Microscopically represented by elongated cells with elongated nuclei. The degree of polymorphism and cell anaplasia is different in different parts of the tumor, and therefore there are 3 degrees of neurosarcoma malignancy : 1st — tumor tissue is fibrous, relatively poor in cells, with foci of mucous degeneration; 2-I – the tumor tissue consists of interwoven bundles of hyperchromic spindle-shaped cells, less intercellular substance, there is some polymorphism; 3rd – the tumor tissue consists only of polymorphic cells, many mitoses and foci of hemorrhage. Malignant tumors do not always retain clear histological signs of neurogenicity , and their connection with the nerve is not always detected. Clinically , there is a rapid growth rate of neoplasms, infiltration of surrounding tissues, sprouting of muscles, bone structures, blood vessels, which reflects clinical symptoms. Relapses in 60-70% of cases. Metastases are detected in 15-17%. Treatment – surgical, radiation therapy with local hyperthermia in combination with the surgical method.