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Basel H, Bozan N. Cervical paragangliomas: experience of 114 cases in 14 years. Braz J Otorhinolaryngol 2021; 87:127-131. [PMID: 29936213 PMCID: PMC9422744 DOI: 10.1016/j.bjorl.2018.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/25/2018] [Accepted: 05/01/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction and objective To report a single center experience with carotid body paraganglioma cases that were treated by the same surgeon in a city with high prevalence of paragangliomas due to high altitude. Methods We retrospectively investigated the demographic, clinicopathological and radiological data of 104 patients diagnosed with cervical paragangliomas between 2003 and 2017. The patients were classified according to the Shamblin classification. Results In this study a total of 104 patients (33 male and 71 female, with a mean age of 54.6 ± 13 years) diagnosed with cervical paragangliomas located on carotid bifurcation between 2003 and 2017 were included. Among those patients, 10 presented with bilateral tumors and in total, 114 paragangliomas were managed in this period. The mean diameter of the tumors was 5.12 ± 1.45 cm. Malignant tumor was determined in only one (0.9%) patient. All patients were operated. In 12 patients with the tumor diameter larger than 5 cm, preoperative coil embolization was achieved. In 14 patients, preoperative angiographic embolization was employed and in 4 patients intraoperative sclerosing agent injections were performed. Facial paralysis was observed in 2 patients and dysphagia was present in 1 patient, Horner syndrome was seen in 1 patient and hoarseness was reported in 7 patients after operation. All those complications improved during follow-up. Mortality was not reported in any cases. Conclusion Surgery is the definitive treatment for patients with cervical paragangliomas. Although, it may be difficult in patients with the advanced Shamblin types, in experienced hands, complication rates are very low.
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Affiliation(s)
- Halil Basel
- Lokman Hekim University Faculty of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey.
| | - Nazim Bozan
- Yuzuncu Yil University, Faculty of Medicine, Department of Otorhinolaryngology, Van, Turkey
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Ikeda A, Shiga K, Katagiri K, Saito D, Miyaguchi J, Oikawa SI, Tsuchida K, Asakage T, Ozawa H, Nibu KI, Ohtsuki N, Fujimoto Y, Kaneko KI. Multi-institutional survey of carotid body tumors in Japan. Oncol Lett 2018; 15:5318-5324. [PMID: 29552173 DOI: 10.3892/ol.2018.7925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022] Open
Abstract
There has been no attempt to clarify the status of patients with carotid body tumor (CBT) in Japan. This multi-institutional survey analyzed patients with CBT throughout Japan by gathering information on these patients from institutions that performed head and neck surgeries. Information from a total of 150 patients from 25 institutions from the past 20 years was employed in the present survey. There were 87 females and 63 males, and their mean age was 48.0 years old. The most common chief complaint was a neck mass and the mean suffering period was 46.1 months. Eighteen patients had a family history of paragangliomas and fifteen patients had bilateral CBTs. Among the 94 patients who underwent surgery to remove a CBT, 23 patients had tumors classified as Shamblin type I, 59 had type II and 12 had type III. The most frequent feeding artery of these CBTs was the ascending pharyngeal artery. Preoperative embolization of these arteries was effective in reducing blood loss; however, the operation time in Shamblin type I and II tumors was not improved. Thus these results revealed the status of patients with CBT and their treatment throughout Japan.
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Affiliation(s)
- Aya Ikeda
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Kiyoto Shiga
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Katsunori Katagiri
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Daisuke Saito
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Jun Miyaguchi
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Shin-Ichi Oikawa
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Kodai Tsuchida
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University School of Medicine, Tokyo 113-8510, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Kobe 650-0017, Japan
| | - Naoki Ohtsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Kobe 650-0017, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
| | - Ken-Ichi Kaneko
- Department of Otolaryngology-Head & Neck Surgery, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan
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Zhikrivetskaya SO, Snezhkina AV, Zaretsky AR, Alekseev BY, Pokrovsky AV, Golovyuk AL, Melnikova NV, Stepanov OA, Kalinin DV, Moskalev AA, Krasnov GS, Dmitriev AA, Kudryavtseva AV. Molecular markers of paragangliomas/pheochromocytomas. Oncotarget 2017; 8:25756-25782. [PMID: 28187001 PMCID: PMC5421967 DOI: 10.18632/oncotarget.15201] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/23/2017] [Indexed: 12/14/2022] Open
Abstract
Paragangliomas/pheochromocytomas comprise rare tumors that arise from the extra-adrenal paraganglia, with an incidence of about 2 to 8 per million people each year. Approximately 40% of cases are due to genetic mutations in at least one out of more than 30 causative genes. About 25-30% of pheochromocytomas/paragangliomas develop under the conditions of a hereditary tumor syndrome a third of which are caused by mutations in the VHL gene. Together, the gene mutations in this disorder have implicated multiple processes including signaling pathways, translation initiation, hypoxia regulation, protein synthesis, differentiation, survival, proliferation, and cell growth. The present review contemplates the mutations associated with the development of pheochromocytomas/paragangliomas and their potential to serve as specific markers of these tumors and their progression. These data will improve our understanding of the pathogenesis of these tumors and likely reveal certain features that may be useful for early diagnostics, malignancy prognostics, and the determination of new targets for disease therapeutics.
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Affiliation(s)
| | | | - Andrew R Zaretsky
- M.M. Shemyakin - Yu.A. Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - Boris Y Alekseev
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | | | - Nataliya V Melnikova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Oleg A Stepanov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Alexey A Moskalev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - George S Krasnov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Alexey A Dmitriev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Anna V Kudryavtseva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
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Park S, Kang SY, Kwon GY, Kwon JE, Kim SK, Kim JY, Kim CH, Kim HJ, Moon KC, Pyo JY, Park WY, Park ES, Sung JY, Sung SH, Oh YH, Lee SE, Lee W, Lee JI, Cho NH, Jung SJ, Cho MS, Cho YM, Cho HY, Cha EJ, Chae YS, Choe G, Choi YJ, Huh J, Ro JY. Clinicopathologic Characteristics and Mutational Status of Succinate Dehydrogenase Genes in Paraganglioma of the Urinary Bladder: A Multi-Institutional Korean Study. Arch Pathol Lab Med 2016; 141:671-677. [DOI: 10.5858/arpa.2016-0403-oa] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Because of the limited number of available primary bladder paraganglioma (PBPG) cases, the rates of succinate dehydrogenase (SDH) mutations and the clinicopathologic characteristics of SDH-deficient tumors have not been fully studied.
Objective.—
To define the clinicopathologic and molecular characteristics of PBPGs.
Design.—
A total of 52 PBPGs were collected retrospectively. SDHA and SDHB immunohistochemical stains were performed. In cases of SDHB expression loss, mutation analyses of SDHB, SDHC, and SDHD were performed.
Results.—
The clinicopathologic features were analyzed for 52 cases (M:F = 27:25), with a mean age of 56 years (range, 22–79 years). Tumor sizes were 0.5 to 8 cm (mean, 2.4 cm). Tumor necrosis was present in 5 of 52 cases (10%), involvement of muscularis propria in 41 (79%), and lymphovascular tumor invasion in 6 (12%). During a mean follow-up period of 41 months (range, 1–161 months), 3 of 52 patients (6%) developed metastases, but no one died from the disease. Immunohistochemistry for SDHA and SDHB showed that all cases were SDHA intact. Among them, 43 cases had intact SDHB, whereas 9 cases were SDHB deficient. Compared with the SDHB-intact cases, the SDHB-deficient cases were characterized by large tumor sizes (4.5 versus 1.9 cm; P < .001), a higher number of mitoses per 10 high-powered fields (2.6 versus 0.1; P = .002), and frequent lymphovascular tumor invasion (33% versus 7%; P = .02) and metastases (22% versus 2%; P = .02). Mutational analyses for SDHB, SDHC, and SDHD were performed in 9 SDHB-deficient cases. Among them, 6 cases were successfully sequenced and revealed SDHB mutations only.
Conclusions.—
Large tumor size, a higher number of mitoses, and the presence of lymphovascular tumor invasion and SDHB mutations suggest malignant paraganglioma.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jae Y. Ro
- From the Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea (Drs S. Park, S.H. Sung, and M.S. Cho); the Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea (Drs Kang and G.Y. Kwon); the Department of Pathology, Ajou University School of Medicine, Suwon, Korea (Dr J.E. Kwon); the Departm
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