Groblewski Jan C, Thekdi Apurva, Carrau Ricardo L
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA 15213, USA.
Am J Otolaryngol. 2004 Jul-Aug;25(4):295-300. doi: 10.1016/j.amjoto.2004.02.007.
Paragangliomas are rare tumors that derive from neural crest tissue. Vagal paragangliomas account for only 3% of all head and neck paragangliomas. Patients with vagal paragangliomas typically present with an asymptomatic neck mass and, less frequently, with cranial neuropathies. It is estimated that only 1% to 3% of all head and neck paragangliomas secrete catecholamines. The incidence of secreting vagal paragangliomas is even smaller. The diagnosis of a secreting paraganglioma involves the use of a screening test for serum catecholamines and a 24-hour urinary test for catecholamine metabolites. The identification and staging of these tumors can be performed through the use of MRI and/or CT scans and an octreotide scintigraphy. The mainstay treatment is surgical extirpation; however, preoperative medical blockade is critical to avoid a hypertensive crisis intra-operatively. We present two illustrative cases of secreting vagal paragangliomas involving a complex diagnostic and therapeutic algorithm.
副神经节瘤是起源于神经嵴组织的罕见肿瘤。迷走神经副神经节瘤仅占所有头颈部副神经节瘤的3%。迷走神经副神经节瘤患者通常表现为无症状的颈部肿块，较少见的表现为颅神经病变。据估计，所有头颈部副神经节瘤中只有1%至3%会分泌儿茶酚胺。分泌性迷走神经副神经节瘤的发生率更低。分泌性副神经节瘤的诊断包括血清儿茶酚胺筛查试验和24小时尿儿茶酚胺代谢产物检测。这些肿瘤的识别和分期可通过MRI和/或CT扫描以及奥曲肽闪烁扫描来进行。主要治疗方法是手术切除；然而，术前药物阻断对于避免术中高血压危象至关重要。我们展示了两例分泌性迷走神经副神经节瘤的病例，涉及复杂的诊断和治疗方案。
