Recurrence and Progression of Head and Neck Paragangliomas after Treatment

2020 ◽  
Vol 162 (4) ◽  
pp. 504-511
Author(s):  
Kevin J. Contrera ◽  
Valeda Yong ◽  
Chandana A. Reddy ◽  
Sara W. Liu ◽  
Robert R. Lorenz
Keyword(s):  
Head And Neck ◽  
Carotid Body ◽  
Lower Risk ◽  
Care Center ◽  
Tertiary Care ◽  
Cox Proportional Hazards ◽  
Risk Of Recurrence ◽  
Glomus Jugulare ◽  
Carotid Body Tumors ◽  
Head And Neck Paragangliomas

Objective To characterize the recurrence of head and neck paragangliomas and the factors associated with disease progression after treatment. Study Design Retrospective cohort study. Setting Tertiary care center. Subjects and Methods In total, 173 adults with 189 paragangliomas (41.3% carotid body, 29.1% glomus jugulare, 19.0% glomus tympanicum, and 10.6% glomus vagale) treated between 1990 and 2010 were evaluated to determine the incidence and risk of recurrence using Cox proportional hazards. Results The mean (SD) follow-up duration was 8.6 (9.1) years. The incidence was 2.92 recurrences per 100 person-years. The rate of recurrence was 8.2% (95% confidence interval [CI], 3.7-12.7) after 4 years and 17.1% (95% CI, 10.2-24.0) after 10 years. Glomus jugulare tumors were more likely to recur (hazard ratio [HR], 3.69; 95% CI, 1.70-8.01; P < .001) while carotid body tumors were less likely (HR, 0.44; 95% CI, 0.21-0.97; P = .041). Radiation had a lower risk of recurrence or progression compared to surgical excision (HR, 0.30; 95% CI, 0.10-.94; P = .040). Recurrence was associated with right-sided paragangliomas (HR, 3.60; 95% CI, 1.63-7.75; P = .001). The median time to recurrence was 18.4 years. Six (3.2%) patients developed metastasis, which was more common with local recurrence (9.5% vs 1.4%, P = .015). Conclusions Recurrence is more common with glomus jugulare tumors and less common with carotid body tumors. Radiation may have a lower risk of recurrence or progression than surgery for some paraganglioma types. Metastasis is rare but more likely with recurrent disease. Surveillance neck imaging is recommended every several years for decades after treatment.

scholarly journals Head-and-neck paragangliomas are associated with sleep-related complaints, especially in the presence of carotid body tumors

2011 ◽  
Vol 16 (2) ◽  
pp. 527-534 ◽  
Author(s):  
Bas Havekes ◽  
Florine Kastelein ◽  
Agatha A. van der Klaauw ◽  
Nicolette van Duinen ◽  
Jeroen C. Jansen ◽  
...  
Keyword(s):  
Head And Neck ◽  
Carotid Body ◽  
Carotid Body Tumors ◽  
Head And Neck Paragangliomas

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

2019 ◽  
Vol 08 (04) ◽  
pp. 237-240 ◽  
Author(s):  
Shuchita Singh ◽  
Renu Madan ◽  
Manoj Kumar Singh ◽  
Alok Thakar ◽  
Suresh Chandra Sharma
Keyword(s):  
Head And Neck ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Location ◽  
Treatment Modalities ◽  
High Morbidity ◽  
Management Options ◽  
Familial Predisposition ◽  
Appropriate Therapy ◽  
Head And Neck Paragangliomas

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.

scholarly journals Management of Multiple Head and Neck Paragangliomas With Assistance of a 3-D Model

2021 ◽  
pp. 014556132110094
Author(s):  
Lifeng Li ◽  
Hongbo Xu ◽  
Xiaohong Chen ◽  
Zhenya Yu ◽  
Jing Zhou ◽  
...  
Keyword(s):  
Head And Neck ◽  
Genomic Analysis ◽  
Study Cohort ◽  
Bilateral Carotid ◽  
Succinate Dehydrogenase Complex ◽  
Carotid Body Tumors ◽  
D Model ◽  
Vessel Rupture ◽  
Head And Neck Paragangliomas ◽  
Succinate Dehydrogenase Complex Subunit

Introduction: Extirpation of multiple head and neck paragangliomas carries challenge due to close anatomic relationships with critical neurovascular bundles. Objectives: This study aims to assess whether the application of 3-D models can assist with surgical planning and treatment of these paragangliomas, decrease surgically related morbidity and mortality. Methods: Fourteen patients undergoing surgical resection of multiple head and neck paragangliomas were enrolled in this study. A preoperative 3-D model was created based on radiologic data, and relevant critical anatomic relationships were preoperatively assessed and intraoperatively validated. Results: All 14 patients presented with multiple head and neck paragangliomas, including bilateral carotid body tumors (CBT, n = 9), concurrent CBT with glomus jugulare tumors (GJT, n = 4), and multiple vagal paragangliomas (n = 1). Ten patients underwent genomic analysis and all harbored succinate dehydrogenase complex subunit D (SDHD) mutations. Under guidance of the 3-D model, the internal carotid artery (ICA) was circumferentially encased by tumor on 5 of the operated sides, in 4 (80%) of which the tumor was successfully dissected out from the ICA, whereas ICA reconstruction was required on one side (20%). Following removal of CBT, anterior rerouting of the facial nerve was avoided in 3 (75%) of 4 patients during the extirpation of GJT with assistance of a 3-D model. Two patients developed permanent postoperative vocal cord paralysis. There was no vessel rupture or mortality in this study cohort. Conclusion: The 3-D model is beneficial for establishment of a preoperative strategy, as well as planning and guiding the intraoperative procedure for resection of multiple head and neck paragangliomas.

Head and Neck Cancer—A Clinicopathological Study in a Tertiary Care Center

2008 ◽  
Vol 100 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Bukola F Adeyemi ◽  
Lola V Adekunle ◽  
Bamidele M Kolude ◽  
Effiong E.U. Akang ◽  
Jonathan O. Lawoyin
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Clinicopathological Study

scholarly journals Tinnitus With Unexpected Spanish Roots: Head and Neck Paragangliomas Caused by SDHAF2 Mutation

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Laura Maria Roose ◽  
Niels J Rupp ◽  
Christof Röösli ◽  
Nadejda Valcheva ◽  
Achim Weber ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Head And Neck ◽  
Carotid Body ◽  
Loss Of Function ◽  
Negative Family History ◽  
Paraganglioma Syndrome ◽  
Plasma Free Metanephrines ◽  
The Right ◽  
Head And Neck Paragangliomas

Abstract It is estimated that up to 40% of all head and neck paragangliomas (HNPGL) have a hereditary background with the most common mutations being found in the succinate dehydrogenase (SDH) genes. SDHAF2 mutation leads to the rare paraganglioma syndrome 2. The authors present the case of a 15-year-old male patient with 2, non-secretory HNPGLs, presenting with left-sided, pulsatile tinnitus, and hearing loss. Imaging led to the suspicion of a jugulotympanic paraganglioma on the left, as well as a carotid body tumor on the right. After resection of the jugulotympanic tumor, histology confirmed the presence of a paraganglioma; immunohistochemistry furthermore suggested a loss of SDHB expression. Genetic testing revealed a rare germline, loss-of-function mutation in the SDHAF2 gene, previously described to cause hereditary paraganglioma syndrome 2. Twenty months after the first operation, the patient underwent a resection of the right carotid body paraganglioma. Plasma-free metanephrines/catecholamines always remained within the reference range; the patient is under regular follow-up, and his relatives will be screened. Our findings emphasize the relevance of genetic testing in patients with HNPGL, also with negative family history, especially when the patients present at a young age and with multiple lesions.

MicroRNA Expression Profiling of Cutaneous Squamous Cell Carcinomas Arising in Different Sites

2020 ◽  
Vol 163 (3) ◽  
pp. 538-545
Author(s):  
Alexander N. Rock ◽  
Mason D. Fisher ◽  
Gwenyth Amborski ◽  
Dawn C. Allain ◽  
Victoria Klee ◽  
...  
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Mirna Expression ◽  
Statistical Significance ◽  
Care Center ◽  
Normal Skin ◽  
Tertiary Care ◽  
Tissue Samples ◽  
Qrt Pcr ◽  
Candidate Mirnas

Objective To examine the microRNA (miRNA) expression profile of cutaneous squamous cell carcinoma (cSCC) tumors from aggressive head and neck locations compared with nonaggressive anatomic sites and normal controls. Study Design Retrospective analysis of miRNA expression. Setting Tertiary care center. Subjects and Methods Tissue samples were collected from 3 anatomic regions: aggressive head and neck sites (ie, ears/lip), nonaggressive locations (ie, extremities/trunk), and adjacent normal skin. RNA was isolated from tissue cores of 45 samples (18 aggressive sites, 15 nonaggressive sites, and 12 normal-adjacent skin). miRNA expression analysis was completed for approximately 800 miRNAs using the NanoString nCounter panel. Five candidate miRNAs were selected for validation. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed on the original samples plus 30 additional tissue samples (7 aggressive sites, 14 nonaggressive sites, and 9 normal-adjacent skin). Results Five candidate miRNAs with significant differences in miRNA expression ( P < 0 ≤ .001) from discovery samples were selected: miR-21, miR-31, let-7g, miR-93, and miR-22. Relative expression for these miRNAs using qRT-PCR in the new sample set did not reveal any significant differences using 1-way analysis of variance. When sets were combined, miR-21 showed increased expression in aggressive tumors relative to nonaggressive tumors ( P = .009), but no others reached statistical significance. Conclusion cSCC behaves more aggressively when originating from specific anatomical subsites of the head and neck. Of 5 miRNAs evaluated, only miR-21 showed significantly higher expression in tumors from aggressive sites relative to nonaggressive sites. Larger sample sizes are needed to evaluate other miRNAs.

scholarly journals Subgemmal Neurogenous Plaque: A Clinical and Pathologic Review With Comparison to Common Head and Neck Neural Tumors

2019 ◽  
Vol 12 ◽  
pp. 2632010X1983018 ◽  
Author(s):  
Hussein Alnajar ◽  
Thomas R O’Toole ◽  
Diana Murro Lin ◽  
Samer Al-Khudari ◽  
Paolo Gattuso
Keyword(s):  
Head And Neck ◽  
Clinical Data ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Taste Buds ◽  
Nerve Bundles ◽  
Diagnostic Confusion ◽  
The Mean ◽  
Mucosal Lesions

Objective: In humans, subgemmal neurogenous plaques (SNPs) are normally found associated with taste buds. On histology, SNP may be mistaken for a neural neoplasm. The objective of this study was to correctly differentiate SNP among head and neck neural lesions and provide clinical and pathologic information that may assist in avoiding misdiagnosis. To our knowledge, this is the first study to provide an estimate of the degree of overdiagnoses of mucosal lesions in the head and neck mucosal area. Study design: Retrospective pathology and chart review. Methods: All cases of head and neck mucosal neural lesions only in the mucosa of the oral cavity, oropharynx, or larynx from the pathology archives of a single urban tertiary care center between 3/2000 and 6/2017 were obtained. The pathologic and clinical data were reviewed. Results: Twenty-six cases were identified: 9 neuromas, 9 neurofibromas, 2 ganglioneuromas and 6 cases of hyperplastic subepithelial nerve bundles. The mean greatest dimension of SNPs was 2.0 mm (range 1-3 mm) and most were subjacent to taste buds (13 cases). The 20 cases of SNP involved 15 women and 5 men. Their median age was 60 years (range 30-85 years). Clinical data were available in 19 cases. The most common presenting complaint was of a painless lesion (8 patients). Conclusions: This review confirmed the rarity of true neural neoplasms in the head and neck mucosa and estimates the risk of their over diagnosis given the possible diagnostic confusion with SNP.

A Study on Cytomorphological and Histopathological Correlation of Head and Neck Lesions in a Tertiary Care Centre, Bhubaneswar, Odisha

2021 ◽  
Vol 8 (33) ◽  
pp. 3104-3109
Author(s):  
Anima Hota ◽  
Pranita Mohanty ◽  
Mitu Mohanty
Keyword(s):  
Head And Neck ◽  
Care Center ◽  
Tertiary Care ◽  
Malignant Lesion ◽  
Tertiary Care Centre ◽  
Anatomic Site ◽  
Histopathological Findings ◽  
Statistical Measures ◽  
Neoplastic Lesions ◽  
Thyroid Lesions

BACKGROUND The head and neck region is an anatomic site having lymph nodes, nerves, veins, arteries, muscles, mucosal epithelium to salivary glands, thyroid, and a host of developmental tissues. Any of these tissues can become pathological, resulting in a mass. Fine needle aspiration cytology (FNAC) is regarded as a reliable method of investigation in diagnosis of head and neck lesions. However, histopathology is the gold standard of diagnosis. The purpose of this study was to assess the frequency of head and neck tumours according to the sites of their occurrence and to find out the correlation of cytopathological findings by FNAC and histopathological findings by biopsy. METHODS This prospective study undertaken from June 2012 to June 2014 in the Department of Pathology, IMS and SUM Hospital, Bhubaneswar, a tertiary care center. All the patients attending different outdoor of IMS & SUM Hospital, Bhubaneswar with head & neck lesions referred for FNAC were included in the study. The results of FNAC were compared with that of histopathological findings by tissue biopsy. Data collected was entered in MS Excel and analysed using the same software. Descriptive statistical measures like frequency and percentage. Data was presented in tabular form. RESULTS The commonest site of lesion was in the lymph node followed by thyroid gland. There was preponderance of female sex in thyroid lesions whereas males were commonest in other sites. The accuracy in cyto-histopathology correlation between benign and malignant lesion was 96.36 % and 88.89 % respectively and was most corroborated in the thyroid lesions (50.6 %). CONCLUSIONS Cyto-histo correlation of head and neck lesions provides an important, quick, excellent, and sensitive diagnostic tool to exclude non-neoplastic lesions from neoplastic lesions. KEYWORDS Head and Neck Lesions, FNAC, Histopathology

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