Papillary Thyroid Carcinoma in Patients with Carotid Body Tumors: Prevalence and Management in a Retrospective Surgical Series from Two Tertiary Centers

TL;DR

This study finds that 25% of patients with carotid body tumors also have papillary thyroid cancer, suggesting possible genetic links or increased diagnostic attention.

Contribution

The study reports a higher-than-expected prevalence of concurrent papillary thyroid carcinoma in patients with carotid body tumors.

Findings

25% of patients with carotid body tumors had confirmed papillary thyroid carcinoma.

No recurrences were observed during follow-up for patients with both tumor types.

Both single-stage and staged surgical approaches were safely used for managing dual pathology.

Abstract

Background/Objectives: The co-occurrence of a carotid body tumor (CBT) and papillary thyroid carcinoma (PTC) is a rare clinical event. The frequency of this dual pathology in recent reports has sparked a debate on whether it represents a true pathophysiological association or an artifact of increased diagnostic surveillance. This study aims to report the prevalence, clinicopathological characteristics, management, and outcomes of concurrent CBT and PTC in a contemporary cohort. Methods: We conducted a retrospective review of patients who underwent CBT resection at two tertiary centers between 2014 and 2024. Data on patient demographics, tumor characteristics, preoperative imaging, surgical management (single stage vs. staged), final histopathology, and clinical outcomes were collected and analyzed. Results: Overall, 32 patients with surgically resected CBTs were included. Eleven patients (34.4%) had thyroid nodules identified on preoperative imaging. The mean age of the participants was 57.2 ± 16.3 years. Females represented the majority of the population (n = 27, 84.4%). Nine patients underwent thyroid surgery with subsequent pathological confirmation. Management involved resection at two different time intervals in five cases (55.6%) and a single-stage operation in four (44.4%). On final pathology, PTC was confirmed in eight patients (25.0%). During the follow-up period, no recurrences of either tumor type were observed. Conclusions: The prevalence of concurrent PTC in patients with CBTs is significantly higher than previously reported, reaching 25% in our cohort. This incidental finding raises the possibility of surveillance bias or underlying genetic mechanisms. Management with either a single-stage or staged surgical approach was not associated with major complications. The prognosis for patients with this dual pathology is excellent and appears to be dictated by the independent characteristics of each tumor.