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Paragangliomas are tumors that arise from the paraganglia that are distributed in the head and neck from skull base to aortic arch. The most commonly described sites are the aortic bodies, the temporal bone, and the vagal body. Rarely have these tumors been described in areas where there is apparently no paraganglionic tissue. Twenty four confirmed paragangliomas located in the nasal cavity and the paranasal sinus have been reported, only 4 of which were malignant. 1,2 We report the fifth case of malignant nasal paraganglioma and the first multifocal form described in this area. CASE REPORTA 72-year-old woman presented to our department with a painless mass in the right submandibular triangle that appeared 5 months earlier, progressively increasing in size. Her medical history was unremarkable except for a right nasal polypectomy performed at another institution 7 years earlier. Cytologic analysis of a fine needle puncture realized on the node revealed weakly basophil cells organized in nests, suggesting a paraganglioma.Surgical exploration, performed to make a diagnosis, found a lymph node adhered to the submandibular gland that was removed.

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Objective: To evaluate the possibility of preservation of the larynx after neoadjuvant chemotherapy by performing a conservative surgery instead of total laryngectomy initially planned, in patients with previously untreated laryngeal and piriform sinus squamous cell carcinoma (SCC). Study Design: Retrospective study. Methods: A total of 115 patients treated at Tenon Hospital with induction chemotherapy from 1985 to 1995, all with initial indication of radical surgery, were available for the study. The clinical tumor response was evaluated after three cycles of chemotherapy. According to this response, to preserve laryngeal functions, some patients had a modification of the treatment initially planned: radiation therapy essentially for complete responders, and conservative surgery for some partial responders. Results: Of 69 patients with laryngeal cancer, 14 were treated by partial laryngectomy and 19 by radiation therapy; of 46 patients with piriform sinus cancer, 8 were treated by partial surgery and 12 by radiation therapy; the other patients were treated as was initially planned (total laryngectomy with partial pharyngectomy). Overall survival rates, estimated by the Kaplan-Meier method, were not statistically different between the three treatment groups. The laryngeal functions were preserved in 54% of the patients who were alive at 3 years. Conclusion: This report is a retrospective study, but these results suggest the possibility of using conservative surgery, instead of initially planned total laryngectomy, for good responders to induction chemotherapy with a small residual tumor.