Diagnosis and treatment of supraglottic laryngeal paraganglioma: report of a case

Abstract

Preoperative CT and angiography are useful in making the diagnosis of paraganglioma before surgical intervention. Complete excision through an external mucosa-sparing approach is the treatment of choice. Distinguishing laryngeal paraganglioma from other neuroendocrine tumors can be difficult. Immunohistochemistry is an important tool for the correct pathologic diagnosis.

Laryngeal Paraganglioma: A Rare Clinical Entity Managed by Supraselective Embolization and Lateral Pharygotomy

“…Atypical carcinoids of the larynx show immunoreactivity for both neuroendocrine markers and epithelial markers [6].…”

“…Most of the laryngeal paragangliomas are managed surgically and organ preservation partial laryngectomy procedures are becoming the standard protocol [1,6]. Radical surgeries are not indicated as regional and distant metastasis are rarely documented [1,6].…”

“…They are highly vascularized tumors involving the walls of the blood vessels or specific nerves [3][4][5]. In the larynx they arise from superior or inferior laryngeal paraganglia and are seen in the supraglottis in 90 % of the cases [6]. Since these tumors are from neural crest-derived cells of the parasympathetic nervous system, they usually appear adjacent to nerve structures, most commonly the superior laryngeal nerve or the recurrent laryngeal nerve [7].…”

“…The paragangliomas of the larynx show a female preponderance compared to other neuroendocrine tumors [6]. Other neuroendocrine tumors differ in their biologic behavior, management, and prognosis compared to paragangliomas and so immunohistochemical differentiation forms an important criteria [8].…”

“…Other neuroendocrine tumors differ in their biologic behavior, management, and prognosis compared to paragangliomas and so immunohistochemical differentiation forms an important criteria [8]. Paragangliomas of larynx are benign submucosal lesion and the management includes a conservative resection [6]. Significant intraoperative blood loss is expected so preoperative transarterial embolization has proved beneficial [9,10].…”