Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-26T06:46:29.573Z Has data issue: false hasContentIssue false
  • English
  • Français

Active surveillance management of head and neck paragangliomas: case series and review of the literature

Published online by Cambridge University Press:  17 April 2017

L Harrison  and
R Corbridge
L Harrison*
Affiliation:
Department of ENT, Head and Neck Surgery, Northampton General Hospital, UK
R Corbridge
Affiliation:
Department of ENT, Head and Neck Surgery, Royal Berkshire Hospital, Reading, UK
*
Address for correspondence: Ms Laura Harrison, Department of ENT, Head and Neck Surgery, Northampton General Hospital, Northampton, UK E-mail: lauraharrison707@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Head and neck paragangliomas are rare. They are usually slow-growing, benign, non-catecholamine secreting tumours, traditionally treated with surgical excision. Complications of surgical excision include lower cranial nerve palsies, stroke and death.

Method:

A retrospective case note analysis was conducted of patients with head and neck paragangliomas treated with a watch-and-scan policy from March 2003 to September 2015, and the relevant literature was reviewed.

Results:

Fifteen head and neck paragangliomas were identified. None of the patients developed a new lower cranial nerve palsy or progression of their presenting hearing loss during the follow-up period. Five patients displayed an increase in maximum linear dimension of 4 mm over an average of 57.4 months. A review of the literature showed that a watch-and-surveillance scan policy is evolving as a treatment option for head and neck paragangliomas without malignant risk factors.

Conclusion:

Readily available surveillance scanning in head and neck paragangliomas enables the monitoring of head and neck paragangliomas, which may allow for avoidance of major surgery.

Keywords

ParagangliomasHead And Neck NeoplasmsSurgeryMedical Imaging
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 7 , July 2017 , pp. 580 - 584
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Sykes, JM, Ossoff, RH. Paragangliomas of the head and neck. Otolaryngol Clin North Am 1986;19:755–67CrossRefGoogle ScholarPubMed
2 Van den Berg, R. Imaging and management of head and neck paragangliomas. Eur Radiol 2005;15:1310–18CrossRefGoogle ScholarPubMed
3 Havekes, B, Corssmit, EP, Jansen, JC, van der Mey, AG, Vriends, AH, Romijn, JA et al. Malignant paragangliomas associated with mutations in the succinate dehydrogenase D gene. J Clin Endocrinol Metab 2007;92:1245–8CrossRefGoogle ScholarPubMed
4 Boedeker, CC, Neumann, HP, Maier, W, Bausch, B, Schipper, J, Ridder, GJ. Malignant head and neck paragangliomas in SDHB mutation carriers. Otolaryngol Head Neck Surg 2007;137:126–9Google Scholar
5 Patetsios, P, Gable, DR, Garrett, WW, Lamont, JP, Kuhn, JA, Shutze, WP et al. Management of carotid body paragangliomas and review of a 30-year experience. Ann Vasc Surg 2002;16:331–8Google Scholar
6 Chapman, DB, Lippert, D, Geer, CP, Edwards, HD, Russell, GB, Rees, CJ et al. Clinical, histopathologic, and radiographic indicators of malignancy in head and neck paragangliomas. Otolaryngol Head Neck Surg 2010;143:531–7Google Scholar
7 Samji, KB, Crown, AL, Buxton-Thomas, MS, Aylwin, SJ, Schulte, KM, Dizdarevic, S. Necessity for long-term follow-up of patients with head and neck paraganglioma and mutation in the succinate dehydrogenase genes: an index case report and literature review. Endocr Pract 2012;18:e130–4 Google Scholar
8 Obholzer, RJ, Hornigold, R, Connor, S, Gleeson, MJ. Classification and management of cervical paragangliomas. Ann R Coll Surg Engl 2011;93:596–602 CrossRefGoogle ScholarPubMed
9 Netterville, JL, Jackson, CG, Miller, FR, Wanamaker, JR, Glasscock, ME. Vagal paraganglioma: a review of 46 patients treated during a 20-year period. Arch Otolaryngol Head Neck Surg 1998;124:1133–40CrossRefGoogle Scholar
10 Jackson, CG. Glomus tympanicum and glomus jugulare tumours. Otolaryngol Clin North Am 2001;34:941–70Google Scholar
11 Krych, AJ, Foote, RL, Brown, PD, Garces, YI, Link, MJ. Long-term results of irradiation for paraganglioma. Int J Radiat Oncol Biol Phys 2006;65:1063–6CrossRefGoogle ScholarPubMed
12 Kunzel, J, de Tristan, J, Mantsopoulos, K, Koch, M, Baussmerth, M, Zenk, J et al. Experiences in the treatment of patients with multiple head and neck paragangliomas. Am J Otolaryngol 2014;35:294–9Google Scholar
13 Carlson, ML, Sweeney, AD, Wanna, GB, Netterville, JL, Haynes, DS. Natural history of glomus jugulare: a review of 16 tumours managed with primary observation. Otolaryngol Head Neck Surg 2015;152:98–105 Google Scholar
14 Langerman, A, Athavale, SM, Rangarajan, SV, Sinard, RJ, Netterville, JL. Natural history of cervical paragangliomas: outcomes of observation of 43 patients. Arch Otolaryngol Head Neck Surg 2012;138:341–5Google Scholar
15 Cosetti, M, Linstrom, C, Alexiades, G, Tessema, B, Parisier, S. Glomus tumors in patients of advanced age: a conservative approach. Laryngoscope 2008;18:270–4Google Scholar
16 Jansen, JC, van der Berg, R, Kuiper, A, van der Mey, AG, Zwinderman, AH, Cornelisse, CJ. Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 2000;15:2811–16Google Scholar
17 Lack, EE, Cubilla, AL, Woodruff, JM, Farr, HW. Paragangliomas of the head and neck region: a clinical study of 69 patients. Cancer 1977;39:397–409 Google Scholar
18 Van Duinen, N, Steenvoorden, D, Kema, IP, Jansen, JC, Vriends, AH, Bayley, JP et al. Increased urinary extraction of 3-methoxytyramine in patients with head and neck paragangliomas. J Clin Endocrinol Metab 2010;95:209–14CrossRefGoogle Scholar
19 Saldana, MJ, Salem, LE, Travezan, R. High altitude hypoxia and chemodectomas. Hum Pathol 1973;4:251–63Google Scholar
20 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;2:1291–4CrossRefGoogle ScholarPubMed
21 Baysal, BE. Hereditary paraganglioma targets diverse paraganglia. J Med Genet 2002;39:617–22Google Scholar
22 Burnichon, N, Abermil, N, Buffet, A, Favier, J, Gimenez-Roqueplo, AP. The genetics of paragangliomas. Eur Ann Otorhinolaryngol Head Neck Dis 2012;129:315–18Google Scholar
23 Jackson, CG, McGrew, BM, Forest, JA, Netterville, JL, Hampf, CF, Glasscock, ME 3rd. Lateral skull base surgery for glomus tumors: long-term control. Otol Neurotol 2001;22:377–82Google Scholar
24 Heath, D. The human carotid body in health and disease. J Pathol 1991;164:1–8 Google Scholar
25 Corssmit, EP, Romijn, JA. Clinical management of paragangliomas. Eur J Endocrinol 2014;171:R231–43 Google Scholar
26 Taieb, D, Kaliski, A, Boedeker, CC, Martucci, V, Fojo, T, Adler, JR Jr et al. Current approaches and recent developments in the management of head and neck paragangliomas. Endocr Rev 2014;35:795–819 Google Scholar
27 van den Berg, R, Verbist, BM, Mertens, BJ, van der Mey, AG, van Buchem, MA. Head and neck paragangliomas: improved tumour detection using contrast-enhanced 3D time of flight MR angiography as compared with fat-suppressed MR imaging techniques. Am J Neuroradiol 2004;25:863–70Google ScholarPubMed
28 Neskey, DM, Hatoum, G, Modh, R, Civantos, F, Telischi, FF, Angeli, SI et al. Outcomes after surgical resection of head and neck paragangliomas: a review of 61 patients. Skull Base 2011;21:171–6Google Scholar
29 Fish, J, Klein-Weigel, MD, Biebl, M, Janecke, A, Tauscher, T, Fraedrich, G. Systematic screening and treatment evaluation of hereditary neck paragangliomas. Head Neck 2007;29:864–73Google Scholar
30 de Flines, J, Jansen, J, Elders, R, Siemers, M, Vriends, A, Hes, F et al. Normal life expectancy for paraganglioma patients: a 50-year-old cohort revisited. Skull Base 2011;21:385–8Google Scholar
31 Piazza, P, Di Lella, F, Bacciu, A, Di Trapani, G, Ait Mimoune, H, Sanna, M. Preoperative protective stenting of the internal carotid artery in the management of complex head and neck paragangliomas: long-term results. Audiol Neurootol 2015;18:345–52Google Scholar
32 Sethi, RS, Sethi, RK, Herr, MW, Deschler, DG. Malignant head and neck paragangliomas: treatment efficacy and prognostic indicators. Am J Otolaryngol 2013;34:431–8CrossRefGoogle ScholarPubMed