Head-and-neck paragangliomas: An overview of 54 cases operated at a tertiary care center

Shuchita Singh; Renu Madan; Manoj Kumar Singh; Alok Thakar; Suresh Chandra Sharma

doi:10.4103/sajc.sajc_339_18

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ORIGINAL ARTICLE: Head and Neck Cancers

08 (

); 237-240

doi:

10.4103/sajc.sajc_339_18

Head-and-neck paragangliomas: An overview of 54 cases operated at a tertiary care center

Shuchita Singh^1,, Renu Madan², Manoj Kumar Singh³, Alok Thakar¹, Suresh Chandra Sharma¹

1 Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi

2 Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi

3 Department of Pathology, All India Institute of Medical Sciences, New Delhi

*Corresponding author: Dr. Shuchita Singh. drshuch@yahoo.com

Published: 2020-12-14

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Background: Head-and-neck paragangliomas (HNP’s) are rare autonomic neoplasms associated with high morbidity and mortality. We aimed to study epidemiology, clinicopathological correlation, and management of HNP to assist clinicians in advocating the most appropriate therapy. Materials and Methods: Epidemiological parameters, including age and sex distribution, clinical presentation, tumor classification, familial predisposition, multicentricity, and treatment modalities adopted, were analyzed in this retrospective analysis of 54 patients of HNP. Results: Age ranged from 15 to 85 years, with a female preponderance. Among all HNP, carotid body tumor (CBT) (48.1%) was the most common, followed by Glomus Jugulare (24.1%). Majority of the patients presented with neck swelling associated with nerve palsies. A preoperative neurological deficit was most commonly observed with Glomus jugulotympanicum (68.4%). Conclusion: CBT is the largest and most common paraganglioma in our study. The familial occurrence warrants meticulous screening for multifocality. Tumor location, neurovascular involvement, malignant potential, and patient factors should guide the designing of management options.

Keywords

References

Bayley JP, van Minderhout I, Weiss MM, Jansen JC, Oomen PH, Menko FH, et al. Mutation analysis of SDHB and SDHC: Novel germline mutations in sporadic head and neck paraganglioma and familial paraganglioma and/or pheochromocytoma. BMC Med Genet 2006;7:1.
Sykes JM, Ossoff RH. Paragangliomas of the head and neck. Otolaryngol Clin North Am 1986;19:755-67.
Wasserman PG, Savargaonkar P. Paragangliomas: Classification, pathology, and differential diagnosis. Otolaryngol Clin North Am 2001;34:845-62, v-vi.
van der Mey AG, Maaswinkel-Mooy PD, Cornelisse CJ, Schmidt PH, van de Kamp JJ. Genomic imprinting in hereditary glomus tumours: Evidence for new genetic theory. Lancet 1989;2:1291-4.
Heutink P, van der Mey AG, Sandkuijl LA, van Gils AP, Bardoel A, Breedveld GJ, et al. A gene subject to genomic imprinting and responsible for hereditary paragangliomas maps to chromosome 11q23-qter. Hum Mol Genet 1992;1:7-10.
Gimm O, Koch CA, Januszewicz A, Opocher G, Neumann HP. The genetic basis of pheochromocytoma. Front Horm Res 2004;31:45-60.
Springate SC, Weichselbaum RR. Radiation or surgery for chemodectoma of the temporal bone: A review of local control and complications. Head Neck 1990;12:303-7.
Tubiana M, Pejovic MH, Koscielny S, Chavaudra N, Malaise E. Growth rate, kinetics of tumor cell proliferation and long-term outcome in human breast cancer. Int J Cancer 1989;44:17-22.
Pastores GM, Michels VV, Jack CR Jr. Early childhood diagnosis of acoustic neuromas in presymptomatic individuals at risk for neurofibromatosis 2. Am J Med Genet 1991;41:325-9.
Green JD Jr., Brackmann DE, Nguyen CD, Arriaga MA, Telischi FF, De la Cruz A, et al. Surgical management of previously untreated glomus jugulare tumors. Laryngoscope 1994;104:917-21.
Bishop GB Jr., Urist MM, el Gammal T, Peters GE, Maddox WA. Paragangliomas of the neck. Arch Surg 1992;127:1441-5.
Netterville JL, Reilly KM, Robertson D, Reiber ME, Armstrong WB, Childs P, et al. Carotid body tumors: A review of 30 patients with 46 tumors. Laryngoscope 1995;105:115-26.
Jansen JC, van den Berg R, Kuiper A, van der Mey AG, Zwinderman AH, Cornelisse CJ, et al. Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 2000;88:2811-6.
Capatina C, Ntali G, Karavitaki N, Grossman AB. The management of head-and-neck paragangliomas. Endocr Relat Cancer 2013;20:R291-305.
Spratt JS, Meyer JS, Spratt JA. Rates of growth of human neoplasms: Part II. J Surg Oncol 1996;61:68-83.
Nedzelski JM, Canter RJ, Kassel EE, Rowed DW, Tator CH. Is no treatment good treatment in the management of acoustic neuromas in the elderly? Laryngoscope 1986;96:825-9.
Valvassori GE, Guzman M. Growth rate of acoustic neuromas. Am J Otol 1989;10:174-6.
Levo H, Pyykkö I, Blomstedt G. Non-surgical treatment of vestibular schwannoma patients. Acta Otolaryngol Suppl 1997;529:56-8.
Wazen J, Silverstein H, Norrell H, Besse B. Preoperative and postoperative growth rates in acoustic neuromas documented with CT scanning. Otolaryngol Head Neck Surg 1985;93:151-5.
Strasnick B, Glasscock ME 3rd, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope 1994;104:1115-9.
Deen HG, Ebersold MJ, Harner SG, Beatty CW, Marion MS, Wharen RE, et al. Conservative management of acoustic neuroma: An outcome study. Neurosurgery 1996;39:260-4.

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[1] Bayley JP, van Minderhout I, Weiss MM, Jansen JC, Oomen PH, Menko FH, et al. Mutation analysis of SDHB and SDHC: Novel germline mutations in sporadic head and neck paraganglioma and familial paraganglioma and/or pheochromocytoma. BMC Med Genet 2006;7:1.

[2] Sykes JM, Ossoff RH. Paragangliomas of the head and neck. Otolaryngol Clin North Am 1986;19:755-67.

[3] Wasserman PG, Savargaonkar P. Paragangliomas: Classification, pathology, and differential diagnosis. Otolaryngol Clin North Am 2001;34:845-62, v-vi.

[4] van der Mey AG, Maaswinkel-Mooy PD, Cornelisse CJ, Schmidt PH, van de Kamp JJ. Genomic imprinting in hereditary glomus tumours: Evidence for new genetic theory. Lancet 1989;2:1291-4.

[5] Heutink P, van der Mey AG, Sandkuijl LA, van Gils AP, Bardoel A, Breedveld GJ, et al. A gene subject to genomic imprinting and responsible for hereditary paragangliomas maps to chromosome 11q23-qter. Hum Mol Genet 1992;1:7-10.

[6] Gimm O, Koch CA, Januszewicz A, Opocher G, Neumann HP. The genetic basis of pheochromocytoma. Front Horm Res 2004;31:45-60.

[7] Springate SC, Weichselbaum RR. Radiation or surgery for chemodectoma of the temporal bone: A review of local control and complications. Head Neck 1990;12:303-7.

[8] Tubiana M, Pejovic MH, Koscielny S, Chavaudra N, Malaise E. Growth rate, kinetics of tumor cell proliferation and long-term outcome in human breast cancer. Int J Cancer 1989;44:17-22.

[9] Pastores GM, Michels VV, Jack CR Jr. Early childhood diagnosis of acoustic neuromas in presymptomatic individuals at risk for neurofibromatosis 2. Am J Med Genet 1991;41:325-9.

[10] Green JD Jr., Brackmann DE, Nguyen CD, Arriaga MA, Telischi FF, De la Cruz A, et al. Surgical management of previously untreated glomus jugulare tumors. Laryngoscope 1994;104:917-21.

[11] Bishop GB Jr., Urist MM, el Gammal T, Peters GE, Maddox WA. Paragangliomas of the neck. Arch Surg 1992;127:1441-5.

[12] Netterville JL, Reilly KM, Robertson D, Reiber ME, Armstrong WB, Childs P, et al. Carotid body tumors: A review of 30 patients with 46 tumors. Laryngoscope 1995;105:115-26.

[13] Jansen JC, van den Berg R, Kuiper A, van der Mey AG, Zwinderman AH, Cornelisse CJ, et al. Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 2000;88:2811-6.

[14] Capatina C, Ntali G, Karavitaki N, Grossman AB. The management of head-and-neck paragangliomas. Endocr Relat Cancer 2013;20:R291-305.

[15] Spratt JS, Meyer JS, Spratt JA. Rates of growth of human neoplasms: Part II. J Surg Oncol 1996;61:68-83.

[16] Nedzelski JM, Canter RJ, Kassel EE, Rowed DW, Tator CH. Is no treatment good treatment in the management of acoustic neuromas in the elderly? Laryngoscope 1986;96:825-9.

[17] Valvassori GE, Guzman M. Growth rate of acoustic neuromas. Am J Otol 1989;10:174-6.

[18] Levo H, Pyykkö I, Blomstedt G. Non-surgical treatment of vestibular schwannoma patients. Acta Otolaryngol Suppl 1997;529:56-8.

[19] Wazen J, Silverstein H, Norrell H, Besse B. Preoperative and postoperative growth rates in acoustic neuromas documented with CT scanning. Otolaryngol Head Neck Surg 1985;93:151-5.

[20] Strasnick B, Glasscock ME 3rd, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope 1994;104:1115-9.

[21] Deen HG, Ebersold MJ, Harner SG, Beatty CW, Marion MS, Wharen RE, et al. Conservative management of acoustic neuroma: An outcome study. Neurosurgery 1996;39:260-4.

Head-and-neck paragangliomas: An overview of 54 cases operated at a tertiary care center

Abstract

Abstract

Keywords

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