Jansen J C, van den Berg R, Kuiper A, van der Mey A G, Zwinderman A H, Cornelisse C J
Department of ENT, Head and Neck Surgery, Leiden University Medical Center, The Netherlands.
Cancer. 2000 Jun 15;88(12):2811-6.
Extraadrenal paragangliomas of the head and neck are tumors with variable clinical behavior. Because tumor growth as well as surgery can cause disabling loss of function, knowledge of the natural history of paragangliomas is important for the development of treatment strategies.
The tumor volume, growth rate, and tumor doubling time of 48 paragangliomas at different anatomic locations in the head and neck region were estimated retrospectively using sequential radiologic imaging.
During a mean follow-up period of 4.2 years, a volume increase of > 20% was observed in 60% of the paragangliomas. In these cases the median growth rate was 1.0 mm/year and the median tumor doubling time was 4. 2 years. More growing tumors were observed in intermediate size tumors than in very small or large paragangliomas, suggesting a biphasic growth pattern.
The majority of head and neck paragangliomas have a very low growth rate. Although management of paragangliomas also is determined by other parameters, preoperative estimation of the tumor doubling time may influence the treatment proposal. A "wait and scan" policy must be considered in all cases.
头颈部肾上腺外副神经节瘤是具有不同临床行为的肿瘤。由于肿瘤生长以及手术可能导致功能丧失，了解副神经节瘤的自然病史对于制定治疗策略很重要。
回顾性地利用连续的放射影像学检查，估计48例位于头颈部不同解剖位置的副神经节瘤的肿瘤体积、生长速率和肿瘤倍增时间。
在平均4.2年的随访期内，60%的副神经节瘤体积增加超过20%。在这些病例中，中位生长速率为每年1.0毫米，中位肿瘤倍增时间为4.2年。中等大小的肿瘤比非常小或非常大的副神经节瘤中观察到更多生长的肿瘤，提示双相生长模式。
大多数头颈部副神经节瘤生长速率非常低。虽然副神经节瘤的治疗也由其他参数决定，但术前估计肿瘤倍增时间可能会影响治疗方案。在所有病例中都必须考虑“等待并扫描”策略。
