Cervical paragangliomas: single centre experience with 44 cases.
Bottom Line: A female prevalence was found (76% of cases).Lymph node metastasis was not found in any patient.Abstract available from the publisher.
Affiliation: Vascular Surgery Unit and.
Paragangliomas (PGL) are rare lesions of the neuroendocrine system; in the neck, they usually affect the carotid glomus (carotid body tumours-CBT). This retrospective analysis reports our experience in management of these lesions in patients treated by surgical resection. Between 2000 and 2014, 33 patients were surgically treated at our institution, obtaining a series of 44 cervical PGLs. Tumour characteristics, family history, diagnostic procedures, surgical treatment, short- and long-term outcomes were reviewed. A female prevalence was found (76% of cases). Familial cases occurred in 9 patients (20%); 6 presented with bilateral lesions and 1 had multiple paragangliomas. Lymph node metastasis was not found in any patient. All lesions were classified into three groups according to the latero-lateral diameter. Complete resection of the PGL was performed in all patients. Mortality was ; transitory cranial nerve deficit occurred in 20% of cases with permanent palsy in 6.7%. No perioperative stroke/TIA were observed. Surgical resection of PGL should be considered as the only therapeutic option because it can ensure complete removal of the disease. Patients with bilateral lesions and positive family history should be referred for genetic analysis. Preoperative planning of the surgical procedure by integrated diagnostic imaging and a full mastery of vascular surgery techniques are mandatory to minimise the risk of the most common postoperative complications. Long-term follow-up is recommended, particularly in patients with familial disease or sporadic lesions treated in an advanced stage.
No MeSH data available.
Related in: MedlinePlus
Mentions: Between 1988 and the time of writing, 33 patients with 44 CBTs have been treated by surgical excision in our unit: 7 men and 26 women with mean age of 55 years. In 16 (48%) patients, the lesion was asymptomatic and diagnosis was incidentally made by ultrasound scan performed for another reason; 15 (45%) patients presented a painless mass in the latero-cervical region; only 2 (7%) patients reported symptoms such as headache, palpitations and local pain. First evaluation was performed, in all patients, by duplex ultrasound. All patients admitted were previously diagnosed by second level examination such as angioCT scan (Fig. 1) or angio MRI scan (Fig. 2) and 131I-MIBG scintigraphy. A detailed list of imaging procedures performed in all patients is given in Table I. Familial cases occurred in 9 patients (20%); of these, 3 patients had bilateral lesions and 1 patient had multiple paragangliomas. No lymph node metastasis was found at preoperative imaging in any case. The lesions were classified into three groups according to the latero-lateral diameter: 17 tumours (40%) in Group I (< 3 cm), 19 (44%) in Group II (3-5 cm), and 8 (16%) in Group III (> 5 cm). Tumours that extended to the skull base were not included in this series. In 22 cases (group II-III), preoperative embolisation of the CBT feeding vessels was performed by superselective carotid angiography (Fig. 3).
No MeSH data available.