Treatment of Head and Neck Paragangliomas

Kenneth Hu, MD; Mark S. Persky, MD

Disclosures

Cancer Control. 2016;23(3):228-241. 

In This Article

Multicentricity

Rarely, sporadic cases (10%) will present with a concurrent second paraganglioma, and multicentricity may be present in up to 85% of those with a genetic predisposition.[6–8] A second carotid body tumor is by far the most common pattern of a synchronous secondary paraganglioma (20% of carotid body tumors).[6–8] An additional contralateral or ipsilateral paraganglioma, as well as bilateral carotid body tumors, poses significant and challenging treatment problems for the clinician, because patients undergoing resection of bilateral carotid body tumors may experience baroreceptor function loss and deficits in the cranial nerves resulting in labile hypertension.[1,2,9] These tumors may be metachronous, indicating that surveillance may be appropriate for select paraganglioma cases. Routine follow-up imaging with magnetic resonance imaging (MRI) or fluorodeoxyglucose/fluorodopa or indium pentetreotide positron emission tomography (PET) is warranted in multicentric, metachronous tumors.[1–3]

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