Numbers
- Possibly the most common paraganglioma (pheochromocytoma may be more common).
- Approximately 5% are bilateral;
- The incidence of bilaterality increases to 26% in familial cases
- These are probably autosomal dominant
Clinical features
- Painless, slow growing mass in upper neck
- Large tumors may → cranial nerve involvement (especially vagus and hypoglossal).
- May also cause stenosis of ICA → TIAs or stroke.
Evaluation
- Carotid angiogram:
- Demonstrates predominant blood supply (usually external carotid, with possible contributions from vertebral and thyrocervical trunk).
- May also detect bilateral lesions
- Characteristic finding: splaying of bifurcation
- MRI (or CT):
- Evaluates extent
- Assesses for intracranial extension
Management
- Resection reported to carry a high complication rate
- Stroke (8–20%)
- Cranial nerve injury (33–44%)
- Mortality rate is 5–13%.
Made with Bullet