Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal

Abstract

BACKGROUND Extraadrenal paragangliomas of the head and neck are tumors with variable clinical behavior. Because tumor growth as well as surgery can cause disabling loss of function, knowledge of the natural history of paragangliomas is important for the development of treatment strategies. METHODS The tumor volume, growth rate, and tumor doubling time of 48 paragangliomas at different anatomic locations in the head and neck region were estimated retrospectively using sequential radiologic imaging. RESULTS During a mean follow‐up period of 4.2 years, a volume increase of > 20% was observed in 60% of the paragangliomas. In these cases the median growth rate was 1.0 mm/year and the median tumor doubling time was 4.2 years. More growing tumors were observed in intermediate size tumors than in very small or large paragangliomas, suggesting a biphasic growth pattern. CONCLUSIONS The majority of head and neck paragangliomas have a very low growth rate. Although management of paragangliomas also is determined by other parameters, preoperative estimation of the tumor doubling time may influence the treatment proposal. A “wait and scan” policy must be considered in all cases. Cancer 2000;88:2811–6. © 2000 American Cancer Society.

Paraganglioma of the Thyroid Gland: A Rare Entity

“…Head and neck paragangliomas usually develop slowly and compare very well with the vestibular schwanoma with a radiologic progression in 40-80% of the cases and a tumor doubling time of 0.6-21.5 years [12]. Nevertheless, the occurrence of malignant paraganglioma have been reported [13], although it is difficult to establish a criteria for malignancy, since the experience with these tumors is relatively small and several studies agree that there are no histological differences and the only diagnostic criterion is [3,7].…”

Fractionated Stereotactic Radiotherapy of Glomus Jugulare Tumors

“…Glomus jugulare tumors are slowly growing, benign lesions [19]. They effect tinnitus and lower cranial nerve palsies (LCNP) [8].…”

Models of parent-of-origin tumorigenesis in hereditary paraganglioma

“…Parasympathetic paragangliomas occur most commonly in the head and neck region and most frequently arise in the carotid body at the bifurcation of the carotid artery, while pheochromocytomas arise in the adrenal medulla and sympathetic paragangliomas occur elsewhere in the abdomen and thorax [1]. Paragangliomas of the head and neck usually show relatively mild symptoms and display a characteristically indolent tumor progression [2]. Prominent characteristics of pheochromocytomas and extra-adrenal paragangliomas are the hypersecretion of catecholamines and elevated blood pressure.…”