CLINICAL CASES   

Otorinolaringologia 2004 March;54(1):51-5

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Two cases of rare neck tumors: a vagal paraganglioma and a hypoglossal nerve paraganglioma

Maselli M., Conforti M., Rispoli P., Apostolou D., Ortensio M., Scovazzi P., Varetto G., Dama E., Raso A. M.

UOADU Chirurgia Vascolare, Ospedale San Giovanni Battista, Torino

Paragangliomas are rare tumors with a benign or malignant course that involve the arterial walls or specific nerves. Vagal paragangliomas account for less than 2.5% of all head and neck tumors and rank third after neoplasms of the carotid body and the jugular glomus. Paragangliomas can be scattered singly, spreading wherever ganglia cells of the sympa-thetic nervous system are present, and they may have a hereditary component. Diagnosis of malignancy can be established only after the onset of metastases. The single most common symptom is an enlarged laterocervical lymph node, although dysphonia, pharyngodynia, Horner’s syndrome, syncope, hemiparesis and aphasia have been reported in some cases. Treatment should take a multidisciplinary approach, involving ENT specialists, vascular surgeons, and radiologists; surgery remains the best treatment strategy with or without previous tumor embolization. Postoperative complications often require a rehabilitation period of speech therapy for phonation and deglutition. The authors present two cases of paraganglioma, the one involving the vagal and the other the hypoglossal nerve. In both cases, the tumors were treated surgically. The postoperative complications commonly associated with this type of surgery included dysphagia, dyspnea, and dysphonia. Notwithstanding the good outcome, both patients are currently being followed up to monitor for possible local recurrence or contralateral occurrence typical of this tumor.