• Journal of Korean Neurosurgical Society
• /
• 제67권1호
• /
• pp.122-129
• /
• 2024

Paragangliomas are rare neuroendocrine tumors that are usually benign in nature. They may be either familial or sporadic in their occurrence. Numerous neuroendocrine tumors are collectively included under the umbrella of paragangliomas. Among them, carotid body tumors and glomus jugulare tumors are extremely rare. Thus, we present a rare case of 29-year-old male who was admitted with hearing difficulties and tinnitus in the left ear, with swelling on the left side of the neck. Based on clinical and radiological findings, a diagnosis of left-sided glomus jugulare with carotid body tumor was made. The patient underwent a two-stage surgery with an interval of approximately 2 months. Histopathology revealed a paraganglioma. Herein, we present the clinical features, imaging findings, management, and a brief review of literature on the classification, evaluation, and management of carotid body and glomus jugulare tumors. Paraganglioma is a slow-growing tumor. The synchronous occurrence of carotid body and glomus jugulare tumors is infrequent. Microsurgical resection remains the primary treatment modality. Therefore, our patient underwent two-stage surgery. The rarity of occurrence and the proximity and adherence to vital neurovascular structures have resulted in the treatment of paragangliomas remaining a challenge.

• Journal of Chest Surgery
• /
• 제55권2호
• /
• pp.174-176
• /
• 2022

Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

• Tuberculosis and Respiratory Diseases
• /
• 제70권2호
• /
• pp.165-169
• /
• 2011

Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.

• 대한골관절종양학회지
• /
• 제13권2호
• /
• pp.130-134
• /
• 2007

부신경절종은 발생학적으로 신경 능선 세포로부터 기원하는 종양으로 두경부에서 가장 많이 발생하나 드물게 종격동, 후복막 등의 내장 기관에서도 생기며 대부분 양성 경과를 보인다. 그 중 흉요추부의 경막내에 발생한 경우는 매우 드물며, 경추나 흉추보다는 요추부에 대부분 발생한다고 보고되었다. 지금까지 흉요추부의 부신경절종이 보고된 예는 드물기에 저자들은 부신경절종이 흉요추부의 경막내 수막외에 발생한 1예를 경험하여, 자기 공명 영상 및 조직학적 특징과 그 치료 결과를 문헌 고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
• /
• 제47권2호
• /
• pp.197-199
• /
• 2014

Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.

• 대한후두음성언어의학회지
• /
• 제16권1호
• /
• pp.76-80
• /
• 2005

Although primary neuroendocrine carcinomas(NEC) are uncommon tumors of the larynx, they represent the most common nonepidermoid malignancy of this organ. Whereas typical carcinoid tumors and small-cell carcinomas occur very rarely in the larynx, the majority of laryngeal NEC belong to a broad intermediate group between these two extremes of NEC. Through many case studies, a major protion of clinicopathologic characteristics of laryngeal NEC have been revealed; however, the gistogenesis of laryngeal NEC is still unknown. The only well-documented normal neuroendocrine structures of the larynx are paraganglions, but the incidence of laryngeal paragangliomas are much lower than that of NEC. Here, we report on three cases of NEC affecting the larynx and the results of searching for neuroendocriene cells in non-neoplastic larynx tissue.

• 대한두경부종양학회지
• /
• 제28권1호
• /
• pp.46-49
• /
• 2012

Primary tumors of the parapharyngeal space are rare and account for only 0.5% of head and neck neoplasm. About 80% of parapharyngeal tumors are benign and 20% are malignant. Parapharyngeal space is classified into the Prestyloid space and the Poststyloid space. The Poststyloid tumors are usually benign lesions such as neurogenic tumors, paragangliomas, vascular tumors, or aneurisms. The origins of prestyloid tumors are much more diverse pathology, the pleomorphic adenoma in parotid deep lobe is most common type. Several surgical approaches have been introduced for management of parapharyngeal tumor, such as transcervical, transparotid-transcervical and the transcervical-transmandibular approaches. This paper is aimed to present a large parapharyngeal space tumor removed via transoral approach. It is possible to remove easier by using microdebrider. The pathologic diagnosis was pleomorphic adenoma.

• Journal of Yeungnam Medical Science
• /
• 제40권4호
• /
• pp.435-441
• /
• 2023

Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient's body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient's inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

• Journal of Chest Surgery
• /
• 제29권9호
• /
• pp.1023-1027
• /
• 1996

경동맥체 종양(carotid body tumor)은 총경동맥 분지부에 위치한 경동맥체 즉 화학 수용기에서 발생하는 종양으로서 그 발생빈도가 드물다. 이 경동맥 체의 기능은 혈액내 화학조성에 의해 호흡,혈압, 맥박수의 반사조절이 이루어지는 것으로 알려져 있다. 조직학적으로 대부분 주세포(chiefcell)로 구성되어 있고 대부분 피막에 쌓여 있으며 분엽성, 압축성으로 서서히 자라나중에 경부혈관을 둘러싸 압박하게되며 그 이외 다른 혈관이나 신경을 누르게 된다. 경동맥체의 치료방법은 수술적 절제, 방사선 조사, 색 전술등이 알려져 있으며 이중 외과적 절제가 대표적인 치료 방법으로 알려져 있다. 하지만 외과적 절제가 쉽지 않고수술중비교적 높은 이병율과뇌혈류 부전으로 인한 반측마비등의 후유증을 유발할 수 있기 때문에 고도의 주의를 요한다. 저자들은 경동맥 체종양으로 진단받고 절제수술을 받은 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제39권9호
• /
• pp.718-721
• /
• 2006

환자는 37세 여자로 잦은 심한 기침을 주소로 내원하였다. 수술 전 시행한 흥부 전산화 단층 촬영상좌상엽 기관지 입구부의 폐종양으로 의심되는 종괴가 발견되었다. 좌상엽 기관지를 거의 완전히 막고 있는 종괴의 기관지 내시경을 통한 조직 생검 결과는 육아조직을 포함한 만성염증 소견을 보였다. 수술적 절제를 시행하였으며 좌상엽 절제술 후 기관지 절단면의 종양 조직 침범 소견이 보여 소매절제술을 시행하였다. 절제된 종양의 수술 후 조직학적 소견은 원발성 폐부신경절종의 특징을 보였다. 부신경절종은 교감신경절에서 발생하는 종양으로 폐의 실질에서 발생하는 원발성 폐부신경절은 매우 희귀한 질병이다. 이에 저자들은 소매절제술을 시행하여 좋은 결과를 얻었기에 치험 결과를 보고 하는 바이다.