Limits...
Vagal Paraganglioma

Wirthlin JDW - MedPix (2011)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Vagal Paraganglioma

History: 29year old woman w/ ~15 year history of a small lateral painless neck mass. She presents now with 1 month persistent hoarse voice following laryngitis. About 1month ago, pt had laryngitis w/ dyphonia that failed to resolve following resolution of other URI symptoms. Pt is an avid amateur singer and is concerned that her ‘breathy hoarse’ voice has not resolved. Pt reports history of painless left lateral neck mass since a teenager; was told by PCM it was a ‘lymph node’. Pt denies mass changing in size or any other issues/complaints. ROS: Denies fever, chills, decreased neck ROM. Denies neck pain, tenderness, dysphagia, odynophagia, or feeling of neck fullness. PMH: Asthma, GERD, Nephrolithiasis during pregnancy, snoring d/t deviated septum. PSH: Lithotripsy, Septoturbinoplasty. No complications. Meds: albuterol prn, flovent prn, omeprazole Allergies: NDKA SH: Full-time homemaker. Married for 6 years. Denies alcohol, smoking, or illicit drug use. FH: Mother and maternal grandmother had migraines and breast cancer. Father had occupational hearing loss and DM2.

Findings: Angiogram: Pre‐surgical Digital Subtraction Angiogram (DSA) reveals tumor splaying the internal and external carotids at the bifurcation. The tumor demonstrates a vascular “blush”. CT: (Axial T2 weighted image with fat‐saturation) Well defined enhancing mass at the level of the left carotid bifurcation. Splays the ICA and ECA with partial encasement.

Ddx: Congenital: Branchial Cleft Cyst Inflammatory: Reactive lymphadenopathy, Abscess Neoplastic: Lymphoma, Salivary Gland Tumors, Neurogenic tumors, Paraganglioma Vascular: Aneurysms of the carotid artery, Hematoma, Pseudoaneurysm

Dxhow: Histology of mass: Chief cells surrounded by sustentacular cells in a collagen stroma.

Exam: VS:HR76, BP 117/67, RR18, O2Sats: 98% on Room Air. BMI 24.3 General: Well nourished, well developed cacausian healthy appearing female in NAD. HEENT: Atraumatic Normocephalic, pupils anicteric equally round reactive to light and accomadation. External Auditory Canals clear bilaterally, TMs clear and mobile. Pink moist mucous membranes. Firm mobile mass in left lateral neck, measuring ~3 cm by palpation without bruit, freely moves horizontally, vertical movement restricted, no palpable LAD, thyroid normal. Heart: Regular Rate, normal S1 and S2, No MRG Pulm: CTAB Abd: soft, NT/ND, no HSM Ext: 2+ pulses, normal reflexes.

No MeSH data available.


Intra-operative photograph of left vagal paraganglioma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX1002&req=5

MPX1002_synpic56133: Intra-operative photograph of left vagal paraganglioma.


Vagal Paraganglioma

Wirthlin JDW - MedPix (2011)

Intra-operative photograph of left vagal paraganglioma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1002&req=5

MPX1002_synpic56133: Intra-operative photograph of left vagal paraganglioma.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Vagal Paraganglioma

History: 29year old woman w/ ~15 year history of a small lateral painless neck mass. She presents now with 1 month persistent hoarse voice following laryngitis. About 1month ago, pt had laryngitis w/ dyphonia that failed to resolve following resolution of other URI symptoms. Pt is an avid amateur singer and is concerned that her ‘breathy hoarse’ voice has not resolved. Pt reports history of painless left lateral neck mass since a teenager; was told by PCM it was a ‘lymph node’. Pt denies mass changing in size or any other issues/complaints. ROS: Denies fever, chills, decreased neck ROM. Denies neck pain, tenderness, dysphagia, odynophagia, or feeling of neck fullness. PMH: Asthma, GERD, Nephrolithiasis during pregnancy, snoring d/t deviated septum. PSH: Lithotripsy, Septoturbinoplasty. No complications. Meds: albuterol prn, flovent prn, omeprazole Allergies: NDKA SH: Full-time homemaker. Married for 6 years. Denies alcohol, smoking, or illicit drug use. FH: Mother and maternal grandmother had migraines and breast cancer. Father had occupational hearing loss and DM2.

Findings: Angiogram: Pre‐surgical Digital Subtraction Angiogram (DSA) reveals tumor splaying the internal and external carotids at the bifurcation. The tumor demonstrates a vascular “blush”. CT: (Axial T2 weighted image with fat‐saturation) Well defined enhancing mass at the level of the left carotid bifurcation. Splays the ICA and ECA with partial encasement.

Ddx: Congenital: Branchial Cleft Cyst Inflammatory: Reactive lymphadenopathy, Abscess Neoplastic: Lymphoma, Salivary Gland Tumors, Neurogenic tumors, Paraganglioma Vascular: Aneurysms of the carotid artery, Hematoma, Pseudoaneurysm

Dxhow: Histology of mass: Chief cells surrounded by sustentacular cells in a collagen stroma.

Exam: VS:HR76, BP 117/67, RR18, O2Sats: 98% on Room Air. BMI 24.3 General: Well nourished, well developed cacausian healthy appearing female in NAD. HEENT: Atraumatic Normocephalic, pupils anicteric equally round reactive to light and accomadation. External Auditory Canals clear bilaterally, TMs clear and mobile. Pink moist mucous membranes. Firm mobile mass in left lateral neck, measuring ~3 cm by palpation without bruit, freely moves horizontally, vertical movement restricted, no palpable LAD, thyroid normal. Heart: Regular Rate, normal S1 and S2, No MRG Pulm: CTAB Abd: soft, NT/ND, no HSM Ext: 2+ pulses, normal reflexes.

No MeSH data available.