Paraganglioma of the Thyroid Gland: A Rare Entity

Abstract

Paragangliomas are neuroendocrine tumors. The thyroid gland is one of the anatomic sites in which paraganglia are not normally located and are exceptionally rare. We report a case of a 36-year-old Hispanic woman with a soft mass measuring about 30 mm in the right thyroid lobe. Patient was operated on and the neoplasm showed microscopically a typical nesting organoid pattern (zellballen). The inmunohistochemical analysis revealed that the tumor showed strongly and diffuse stain for NSE, Synaptophysin, Chromogranin A, and S-100 protein in the sustentacular cells, whereas no inmunoreactivity was detected with antibodies against thyroglobulin, calcitonin, TTF-1, CEA, and AE1-AE3. The MIB-1 labeling showed 7% of neoplastic cells. Head and neck paragangliomas usually develop slowly, and this tumor exhibited a low proliferative activity. In view of the uncertain malignant potential of paragangliomas, we recommended a careful long-term follow-up.

A registry-based study of thyroid paraganglioma: histological and genetic characteristics

“…Thyroid paraganglioma is a rare entity with approximately 60 cases that are reported, including our series (LaGuette et al 1997, Yano et al 2007, Ferri et al 2009, González Poggioli et al 2009, Basu & Viswanathan 2011, Phitayakorn et al 2011, Varsavsky et al 2011, Armstrong et al 2012, Capel 2012, Castelblanco et al 2012, Costinean et al 2012, Evankovich et al 2012, Kieu et al 2012, Mohyuddin et al 2013, Yu et al 2013. A major question is whether the rare entity of thyroid paraganglioma is of practical clinical relevance.…”

Novel germline SDHD deletion associated with an unusual sympathetic head and neck paraganglioma

“…We describe a patient with a newly discovered SDHD mutation who first presented with an asymptomatic parapharyngeal mass and subsequently was found to have a cervical sympathetic PGL. PGLs of the head and neck have been detected in nearly 20 distinct sites 1, 2, 20. However, they are usually seen in 3 locations: the carotid body at the common carotid artery bifurcation, the jugular foramen, and the middle ear.…”

“…Usually, parasympathetic PGLs develop in the head and neck region and sympathetic PGLs derive from sympathetic tissue in the abdominal or thoracic locations. In the head and neck, parasympathetic PGLs occur at highly predictable sites, and the carotid body has been cited as the most common site of occurrence, followed in frequency by the middle ear, jugular foramen, vagus nerve, larynx, pharynx, the ciliary ganglion of the orbit, or the thyroid gland 1, 2. On the other hand, head and neck sympathetic PGLs are exceedingly rare, with no more than 10 cases reported in the literature to date 3–8…”

Primary Melanotic Paraganglioma of Thyroid Gland: Report of a Rare Case With Clinicopathologic and Immunohistochemical Analysis and a Literature Review

“…A comprehensive search of PubMed showed that only 38 cases had been reported in the English literature since 1974. 1–27 However, no case contained melanin. Pigmentary paraganglioma is a special type of paraganglioma that usually occurs in the uterus, 28 orbit, 29 heart, 30 urinary bladder, 31 and temporal horn, 32 with reported cases also in the mediastinum, lumbar spine, retroperitoneum, and others.…”