Paragangliomas of the head and neck

Pellitteri, P

doi:10.1016/j.oraloncology.2003.09.004

Cited by 317 publications

(288 citation statements)

References 69 publications

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“…The zellballen architecture would be highlighted by an S100 protein reaction, a feature not seen in ESSPA. Furthermore, paraganglioma would be positive with tyrosine hydroxylase, while negative for both pituitary hormones and pituitary transcription factors [60][61][62].…”

Section: Differential Diagnosismentioning

confidence: 99%

Ectopic Sphenoid Sinus Pituitary Adenoma (ESSPA) with Normal Anterior Pituitary Gland: A Clinicopathologic and Immunophenotypic Study of 32 Cases with a Comprehensive Review of the English Literature

Thompson

Seethala

Müller

2012

Head and Neck Pathol

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Ectopic sphenoid sinus pituitary adenoma (ESSPA) may arise from a remnant of Rathke's pouch. These tumors are frequently misdiagnosed as other neuroendocrine or epithelial neoplasms which may develop in this site (olfactory neuroblastoma, neuroendocrine carcinoma, sinonasal undifferentiated carcinoma, paraganglioma, melanoma). Thirty-two patients with ESSPA identified in patients with normal pituitary glands (intact sella turcica) were retrospectively retrieved from the consultation files of the authors' institutions. Clinical records were reviewed with follow-up obtained. An immunohistochemical panel was performed on available material. Sixteen males and 16 females, aged 2-84 years (mean, 57.1 years), presented with chronic sinusitis, headache, obstructive symptoms, and visual field defects, although several were asymptomatic (n = 6). By definition, the tumors were centered within the sphenoid sinus and demonstrated, by imaging studies or intraoperative examination, a normal sella turcica without a concurrent pituitary adenoma. A subset of tumors showed extension into the nasal cavity (n = 5) or nasopharynx (n = 9). Mean tumor size was 3.4 cm. The majority of tumors were beneath an intact respiratory epithelium (n = 22), arranged in many different patterns (solid, packets, organoid, pseudorosetterosette, pseudopapillary, single file, glandular, trabecular, insular). Bone involvement was frequently seen (n = 21). Secretions were present (n = 16). Necrosis was noted in 8 tumors. The tumors showed a variable cellularity, with polygonal, plasmacytoid, granular, and oncocytic tumor cells. Severe pleomorphism was uncommon (n = 5). A delicate, salt-and-pepper chromatin distribution was seen. In addition, there were intranuclear cytoplasmic inclusions (n = 25) and multinucleated tumor cells (n = 18). Mitotic figures were infrequent, with a mean of 1 per 10 HPFs and a\1% proliferation index (Ki-67). There was a vascularized to sclerotic or calcified stroma. Immunohistochemistry highlighted the endocrine nature of the tumors, with synaptophysin (97%), CD56 (91%), NSE (76%) and chromogranin (71%); while pan-cytokeratin was positive in 79%, frequently with a dot-like Golgi accentuation (50%). Reactivity with pituitary hormones included 48% reactive for 2 or more hormones (plurihormonal), and 33% reactive for a single hormone, with prolactin seen most frequently (59%); 19% of cases were non-reactive. The principle differential diagnosis includes olfactory neuroblastoma, neuroendocrine carcinoma, melanoma, and meningioma. All patients were treated with surgery. No patients died from disease, although one patient died with persistent disease (0.8 months). Surgery is curative in the majority of cases, although recurrence/persistence was seen in 4 patients (13.8%). In conclusion, ESSPAs are rare, affecting middle aged patients with nonspecific symptoms, showing characteristic light microscopy and immunohistochemical features of their intrasellar counterparts. When encountering a tumor within the sphenoid sinus, ectopic...

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Section: Differential Diagnosismentioning

confidence: 99%

Ectopic Sphenoid Sinus Pituitary Adenoma (ESSPA) with Normal Anterior Pituitary Gland: A Clinicopathologic and Immunophenotypic Study of 32 Cases with a Comprehensive Review of the English Literature

Thompson

Seethala

Müller

2012

Head and Neck Pathol

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“…Although mostly solitary tumours, bilateral and multiple PGs can occur, predominantly in hereditary syndromes [3]. PGs are usually asymptomatic or appear as a painless mass [4]. Electron microscopy has revealed the presence of endocrine granules within the PG cell cytoplams, but only 1-3 % of these tumours are associated with hormonal disorders [5].…”

Section: Introductionmentioning

confidence: 99%

“…Tumour cells are immunoreactive for chromogranin, synaptophysin, neuron specific enolase (NSE), serotonin and neurofilament, whilst negative for S-100 protein. The elongated peripheral sustentacular cells express S-100 protein [4]. Up to 30 % of PGs are associated with inherited conditions, including multiple endocrine neoplasm type 2 (MEN2) syndrome, Von Hippel-Lindau (VHL) disease, neurofibromatosis type 1 (NF1) and familial PG-phaeochromocytoma syndromes (PGL1, PGL2, PGL3 and PGL4) [8].…”

Section: Introductionmentioning

confidence: 99%

“…Patients typically present with a painless swelling in the lateral neck, below the corner of the jaw [4]. Nerve deficits or dysphonia may result from tumour enlargement [10].…”

Section: Introductionmentioning

confidence: 99%

“…The treatment of choice for CBT is surgical resection. Vessel and nerve injury can potentially cause severe morbidity and mortality, the risk increasing with tumour size [4]. Patients unfit for surgery may receive radiotherapy, which has been proposed as an effective alternative [11].…”

Section: Introductionmentioning

confidence: 99%

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Sclerosing Paraganglioma of the Carotid Body: A Potential Pitfall of Malignancy

Santi

Franchi

Saladino

et al. 2014

Head and Neck Pathol

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Paragangliomas (PGs) of the head and neck region are typically benign, slow-growing neuroendocrine tumours. At times, they may exhibit unusual histological features, such as prominent stromal sclerosis (sclerosing PG), which may raise concerns of malignancy. We describe a case of sclerosing PG of the carotid body, emphasizing the value of immunohistochemical stains for differential diagnosis. A 43-year-old woman presented with a painless lump on the neck. A magnetic resonance imaging scan demonstrated a hypervascular lesion of the carotid body, which was surgically excised. Grossly, the lesion measured 1.8 cm at maximum diameter. On microscopic examination, irregular nests and tiny bundles of neoplastic cells were found between thick bands of fibrous tissue. Focal nuclear cytomegaly and marked pleomorphism were noted. Neoplastic cells proved to be immunoreactive for chromogranin, synaptophysin and neuron specific enolase, but negative for cytokeratins, smooth muscle actin and CD34. Ultrastructurally, numerous mitochondria, rough endoplasmic reticulum structures and endocrine granules were seen in the cytoplasm of the tumour cells. On consideration of the above-mentioned clinico-pathological and ultrastructural findings a diagnosis of sclerosing PG was established. Sclerosing PG is a rare entity which may mimic a malignant neoplasm. The recognition of this unusual morphological variant of PG, together with appropriate immunostains, leads to the correct diagnosis.

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Progressive Facial Paralysis Secondary to a Rare Temporal Bone Tumor<subtitle>Glomus Faciale</subtitle>

Parker

Huang²

2011

Arch Otolaryngol Head Neck Surg

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Paragangliomas of the head and neck

Cited by 317 publications

References 69 publications

Ectopic Sphenoid Sinus Pituitary Adenoma (ESSPA) with Normal Anterior Pituitary Gland: A Clinicopathologic and Immunophenotypic Study of 32 Cases with a Comprehensive Review of the English Literature

Ectopic Sphenoid Sinus Pituitary Adenoma (ESSPA) with Normal Anterior Pituitary Gland: A Clinicopathologic and Immunophenotypic Study of 32 Cases with a Comprehensive Review of the English Literature

Sclerosing Paraganglioma of the Carotid Body: A Potential Pitfall of Malignancy

Progressive Facial Paralysis Secondary to a Rare Temporal Bone Tumor<subtitle>Glomus Faciale</subtitle>

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