Presentation
This case is presented to aid physicians should they encounter a neck mass associated with cough. Vagal paraganglioma, although rare, should be part of the differential in such a presentation. 1. [hindawi.com]
The patient in the present study was also living in high altitude. [oatext.com]
PHYSICAL EXAMINATION Vagal paragangliomas present as slowly growing, firm masses in level II of the neck. Although these represent vascular tumors, they generally do not present as pulsatile masses although there may be associated bruits. [entokey.com]
Forty-seven percent (9/19) had vocal cord paralysis at presentation. Angiography was beneficial in helping to make the diagnosis and in identifying synchronous tumors. History of familial paraganglioma was present in 47% (9/19). [pubmed.ncbi.nlm.nih.gov]
The presenting signs and symptoms in this group of patients are shown in Table 1. [jamanetwork.com]
Respiratoric
- Pharyngitis
[…] for surgical resection.1,19-21 The major challenge facing the surgeon after excision of VPs with lower cranial nerve injury or sacrifice is speech and swallowing rehabilitation.34,37 These deficits may result in varying degrees of lingual, palatal, pharyngeal [jamanetwork.com]
[…] approach; HB, House-Brackmann; NED, no existing disease; DOC, died other cause; DOD, died of disease; AWD, alive with disease. 1–16 Cervical swelling: 14 cases CT: 3 cases PCD: 12 cases Tenth CN: 8 cases Tenth, twelfth Recurrences: 0 10 females, 6 males Pharyngeal [ncbi.nlm.nih.gov]
- Pneumonia
The patient was extubated in the operating room; however, the early postoperative period was complicated by cardiopulmonary failure, followed by aspiration pneumonia. The patient died 9 days after surgery. [bmcmedgenomics.biomedcentral.com]
Cardiovascular
- Thrombosis
Thrombosis of the internal carotid artery in one of our patients may have been caused by aggressive handling of the artery. [ncbi.nlm.nih.gov]
Ears
- Tinnitus
Vagal paragangliomas are rare neuroendocrine tumors arising from the neural crest-derived paraganglionic tissue surrounding the vagus nerve, typically presenting as a neck mass associated with hoarseness or pulsatile tinnitus. [hindawi.com]
The most frequent symptoms associated with the paragangliomas in the neck region reported were palpable neck mass (55%), tinnitus (18%), and cranial nerve palsies (16%) [9]. [oatext.com]
They range from pulsatile tinnitus/ringing in the ear to deficits of cranial nerves (such as hoarseness and dysphagia) and intracranial extension associated with an increased risk of death [5]. [bmcmedgenomics.biomedcentral.com]
Musculoskeletal
- Leg Weakness
In 1 patient, postoperative thrombosis of the internal carotid artery developed which resulted in a slight leg weakness. All patients were followed up for a mean period of 75 months (median, 69 months; range, 9 to 156 months). [ncbi.nlm.nih.gov]
Face, Head & Neck
- Neck Mass
Herein a unique case of vagal nerve paraganglioma is presented, where a neck mass was associated with severe fits of coughing upon palpation. 2. Case Report A 70-year-old female presented with a 4-week history of a neck mass. [hindawi.com]
The most frequent symptoms associated with the paragangliomas in the neck region reported were palpable neck mass (55%), tinnitus (18%), and cranial nerve palsies (16%) [9]. [oatext.com]
The most common initial finding was a neck mass. Forty-seven percent (9/19) had vocal cord paralysis at presentation. Angiography was beneficial in helping to make the diagnosis and in identifying synchronous tumors. [pubmed.ncbi.nlm.nih.gov]
Patient 2 A 52-year-old female, complaining from arterial hypertension, was diagnosed with a right-sided neck mass. [bmcmedgenomics.biomedcentral.com]
Neurologic
- Headache
The symptoms may include headaches, hypertension or high blood pressure, palpitations, excessive sweating, and anxiety. Treatment may be difficult because it will jar the paraganglioma to release some hormones. [mountsinai.org]
Symptoms can include: • High blood pressure • Fast heartbeat • Sweating • Headache • Shaking or tremors Lab Tests: If you have symptoms of paraganglioma, your doctor will order lab tests of your urine and blood to check your hormone levels. [cancer.gov]
This can cause episodes of high blood pressure, a rapid heartbeat, sweating, headache and tremors. Paraganglioma treatment most often involves surgery to remove the tumor. [mayoclinic.org]
Patient 4 A 51-year-old female patient was examined for complaints of swelling on the left side of the neck, hoarseness, morning headaches, weakness, and poor sleep. [bmcmedgenomics.biomedcentral.com]
- Cranial Neuropathy
Operative complications and postoperative morbidity related to cranial neuropathies will be discussed. [pubmed.ncbi.nlm.nih.gov]
In addition, the propensity of these tumors to be multicentric and bilateral puts this population at risk not only for multiple cranial neuropathies but also for bilateral neuropathies, and certainly adds to the complexity of medical decision making. [jamanetwork.com]
Treatment
These treatments might be an option for a paraganglioma that spreads to other parts of the body. Clinical trials. Clinical trials are studies of new treatments or new ways of using existing treatments. [mayoclinic.org]
Early treatment consists of dietary modifications with "bland" food. [jamanetwork.com]
Table 2 contains the guidelines of treatment based on this concept. Table 2 Parameters Monofocal AGE < 60 Tenth CN Status Treatment CN, cranial nerve. [ncbi.nlm.nih.gov]
Dilemma in the Treatment of Paediatric Vagal Paraganglioma. [journals.iium.edu.my]
Although the literature is in agreement with regard to epidemiology, diagnosis, and tumor biology, there is some controversy over treatment modalities for these patients. [pubmed.ncbi.nlm.nih.gov]
Prognosis
prognosis, it is important to talk to your doctor. [cancer.gov]
Wnt inhibitory factor 1 (WIF1) methylation and its association with clinical prognosis in patients with chondrosarcoma. Sci Rep. 2017;7(1):1580. Article PubMed PubMed Central CAS Google Scholar Zhao Z, Liu W, Liu J, Wang J, Luo B. [bmcmedgenomics.biomedcentral.com]
Epidemiology
Although the literature is in agreement with regard to epidemiology, diagnosis, and tumor biology, there is some controversy over treatment modalities for these patients. [pubmed.ncbi.nlm.nih.gov]
Prevention
This obturates the paralyzed heminasopharynx, preventing the velopharyngeal insufficiency. [jamanetwork.com]
The necessity to prevent additional cranial nerve deficits influences the therapeutic approach. There is certainly a mortality associated with disease progression and its treatment. [ncbi.nlm.nih.gov]
Clinical characterization of the Pheochromocytoma and Paraganglioma susceptibility genes SDHA, TMEM127, MAX, and SDHAF2 for gene-informed prevention. JAMA Oncol. 2017;3(9):1204–12. [bmcmedgenomics.biomedcentral.com]