Paragangliomas of the head and neck Review
| Authors: | Valero, C.; Ganly, I. |
| Review Title: | Paragangliomas of the head and neck |
| Abstract: | Paragangliomas are rare neuroendocrine tumors that can be found from the skull base to the pelvis. Head and neck paragangliomas have been historically treated with surgery. However, surgical resection adds risk of injury to vascular structures and cranial nerves that can lead to morbidity such as hoarseness, dysarthria, dysphagia, or aspiration. Recently, improved understanding of the behavior of these tumors and increasing experience in non-surgical treatments, such as observation and radiation therapy, have changed the paradigms of management of this entity. Multiple series now show a trend toward a more conservative management, with a higher percentage of patients being observed or treated with radiotherapy. Several factors should be taken into consideration when deciding the most appropriate treatment for head and neck paragangliomas, starting by differentiating carotid body tumors from non-carotid body tumors. In general, surgical resection is normally recommended for carotid body tumors as the complications from treatment are usually minimal. In contrast, for non-carotid body tumors, surgery is often associated with significant functional impairment due to cranial nerve paralysis. As such, non-surgical treatment is now usually recommended for this subset of head and neck paragangliomas. In young patients with no comorbidities and a small to medium carotid body tumors, surgery should be considered. Moreover, surgery should be offered for secreting tumors, malignant tumors, tumors with rapid growth or increase in symptomatology, and when radiotherapy cannot be performed. Conversely, conservative management with active surveillance or radiotherapy can be offered in the remaining cases in order to avoid unnecessary morbidity while still providing acceptable tumor control. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
| Keywords: | cancer surgery; retrospective studies; gene mutation; clinical feature; review; cancer localization; intensity modulated radiation therapy; disease classification; nuclear magnetic resonance imaging; cancer incidence; paraganglioma; computer assisted tomography; retrospective study; cancer genetics; head and neck neoplasms; conservative treatment; family history; sex difference; neck; external beam radiotherapy; catecholamine; head and neck tumor; vagus nerve; cranial nerve neoplasms; digital subtraction angiography; succinate dehydrogenase; carotid body tumor; clinical outcome; germline mutation; chemodectoma; glomus tumor; internal carotid artery; humans; human; vanilmandelic acid; paragangliomas; paraganglioma, extra-adrenal; normetadrenalin; carotid arteriography; carotid body; glomus jugulare |
| Journal Title: | Journal of Oral Pathology & Medicine |
| Volume: | 51 |
| Issue: | 10 |
| ISSN: | 0904-2512 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2022-11-01 |
| Start Page: | 897 |
| End Page: | 903 |
| Language: | English |
| DOI: | 10.1111/jop.13286 |
| PUBMED: | 35178777 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 3 January 2023 -- Source: Scopus |
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