Head and Neck Paragangliomas: A Two-decade Institutional Experience and Algorithm for Management

Overview

Journal Laryngoscope Investig Otolaryngol

Publisher Wiley

Specialty Otorhinolaryngology

Date 2018 Jan 5

PMID 29299512

Citations 33

Authors

Joshua D Smith

Rachel N Harvey

Owen A Darr

Mark E Prince

Carol R Bradford

Gregory T Wolf

Tobias Else

Gregory J Basura

Affiliations

Soon will be listed here.

Abstract

Objectives: Paragangliomas of the head and neck and cranial base are typically benign, slow-growing tumors arising within the jugular foramen, middle ear, carotid bifurcation, or vagus nerve proper. The objective of this study was to provide a comprehensive characterization of our institutional experience with clinical management of these tumors and posit an algorithm for diagnostic evaluation and treatment.

Methods: This was a retrospective cohort study of patients undergoing treatment for paragangliomas of the head and neck and cranial base at our institution from 2000-2017. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic work-up, pre-treatment cranial nerve palsy, treatment modality, utilization of preoperative angiographic embolization, complications of treatment, tumor control and recurrence, and hereditary status (ie, succinate dehydrogenase mutations) were collected and summarized.

Results: The mean (SD) age of our cohort was 51.8 (±16.1) years with 123 (63.4%) female patients and 71 (36.6%) male patients. Catecholamine-secreting lesions were found in nine (4.6%) patients. Fifty-one patients underwent genetic testing, with mutations identified in 43 (20 , 13 7 , 1 and ). Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were variably employed as treatment approaches across anatomic subsites.

Conclusion: An algorithmic approach to clinical management of these tumors, derived from our longitudinal institutional experience and current empiric evidence, may assist otolaryngologists, radiation oncologists, and geneticists in the care of these complex neoplasms.

Level Of Evidence: 4.

Citing Articles

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Head and Neck Paragangliomas: 16-year Single-center Experience and Mini Review on Diagnosis, Treatment, and Follow-up.

Aydemir G, Ardic F, Kara C, Bir F Medeni Med J. 2024; 39(3):192-203.

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Tumor volume changes after stereotactic, hypofractionated and conventional radiotherapy in paragangliomas of head and neck.

Polanowski P, Kotecka-Blicharz A, Tukiendorf A, Amrogowicz N, Nasiek A, Pietruszka A Cancer Med. 2024; 13(17):e70232.

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Management of bilateral head and neck paragangliomas at a single-institution across four decades.

Bellamkonda N, Tooker E, Naumer A, Buchmann L, Kohlmann W, McCrary H Head Neck. 2024; 47(1):386-393.

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Thyroid Paraganglioma: A Rare Manifestation of Paraganglioma Syndrome Associated With Pathogenic Variant in .

Tarasova V, Samuel K, McMullen C, Kushchayev S, Hernandez Prera J, Veloski C JCEM Case Rep. 2024; 2(9):luae135.

PMID: 39156002 PMC: 11327117. DOI: 10.1210/jcemcr/luae135.

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