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Langenbeck's Archives of Surgery

, Volume 391, Issue 4, pp 396–402 | Cite as

Management of cervical paragangliomas: review of a 15-year experience

  • Polichronis Antonitsis
  • Nikolaos Saratzis
  • Ioannis Velissaris
  • Ioannis Lazaridis
  • Nikolaos Melas
  • Georgios Ginis
  • Constantinos Giavroglou
  • Dimitrios Kiskinis
Original Article

Abstract

Background and aims

Cervical paragangliomas are highly vascular neoplasms and should be considered in the evaluation of all lateral neck masses. The aim of this study is to review an institutional experience in the management of these tumors.

Materials and methods

Thirteen patients with 14 paragangliomas were treated in our institution during a period of 15 years. There were eight women (61.5%) and five men (38.5%) with a mean age of 41.3±15 years. A painless lateral neck mass was the main finding in 69.2% of patients. There was no evidence of a functional tumor. Carotid angiography was performed in all patients to define the vascular anatomy of the lesion. The 78.6% of paragangliomas underwent selective embolization of the major feeding arteries. Surgical resection followed within the next 48 h.

Results

The majority of the lesions were paragangliomas of the carotid bifurcation (85.7%), while one patient was diagnosed with a jugular and one with a vagal paraganglioma. In one patient, bilateral paragangliomas in the carotid bifurcation were detected. There was no evidence of malignancy in any case. Preoperative embolization has proven successful in reducing tumor vascularity. Vascular reconstruction was necessary in one patient. The main postoperative complication was transient cranial nerve deficit in seven (53.8%) patients, and a permanent Horner’s syndrome was documented in one patient. No stroke occurred. The jugular paraganglioma was treated with irradiation due to skull base extension with significant symptomatic relief.

Conclusion

Combined therapeutic approach with preoperative selective embolization followed by surgical resection by an experienced team offers a safe and effective method for complete excision of the tumors with a reduced morbidity rate.

Keywords

Paraganglioma Carotid bifurcation Jugular Vagal Neuroendocrine 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Polichronis Antonitsis
    • 1
    • 2
  • Nikolaos Saratzis
    • 1
  • Ioannis Velissaris
    • 1
  • Ioannis Lazaridis
    • 1
  • Nikolaos Melas
    • 1
  • Georgios Ginis
    • 1
  • Constantinos Giavroglou
    • 3
  • Dimitrios Kiskinis
    • 1
  1. 1.A’ Surgical DepartmentAristotle University of ThessalonikiThessalonikiGreece
  2. 2.ThessalonikiGreece
  3. 3.Department of RadiologyAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece

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