Paragangliomas of the sellar region: Report of two cases

Department of Neurological Surgery, University of Washington Medical Center, Seattle.
Neurosurgery (Impact Factor: 3.03). 06/1993; 32(5):844-7. DOI: 10.1097/00006123-199305000-00021
Source: PubMed

ABSTRACT Two cases of paraganglioma arising from the parasellar region are presented. Both occurred in middle-aged women who sought treatment of headaches but who had no endocrinological dysfunction; one case was associated with ophthalmoplegia from cavernous sinus involvement. Diagnosis in both cases was confirmed by typical histological appearance and cytochemical demonstration of immunoreactive chromogranin in tumor cells. The pathological features and possible pathogenesis of parasellar paragangliomas are discussed.

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    ABSTRACT: Objective: To analyze the distribution and radiological findings of paragangliomas of the head and neck region at Siriraj Hospital. Methods: The cases with pathological proven of paragangliomas in the head and neck from January 1996 to December 2003 at Siriraj Hospital were retrospectively reviewed. Clinical presentation and radiologic findings in term of location, size, number, pattern of enhancement, vascularity and bony destruction were analyzed. Results: There were 26 tumors among 22 patients which were 12 females and 10 males, with an average age of 47 years old. By locations, paragangliomas were found as carotid body tumor in 46.2%, glomus tympanicum in 11.5%, glomus vagale in 11.5%, glomus jugulare in 3.8%, glomus jugulotympanicum in 7.6% and rare locations in 19.2%. The unusual locations included sinonasal cavity, sphenoid sinus, supraglottic larynx, thyroid gland and posterior fossa. The presenting symptoms were neck mass in 53.8%, tinnitus in 26.9%, cranial nerve palsy in 19.2%, epistaxis in 3.8%, hoarseness of voice in 3.8%, severe headache in 3.8%. Multicentricity was found in 18%. Aggressive pattern was documented in 15.4%. The radiological findings of paragangliomas in usual locations were all characteristic homogeneous intensely enhanacement or hypervascularity (100%). Those in rare locations had also central necrosis (60%). Bony destruction was shown in 9.5% of usual locations and 40% of unusual locations. No any of lesions in rare locations had multicentricity. Conclusion: Carotid body tumor is the most common paragangliomas in the head and neck region. Clinical presentation of a paraganglioma is related to location of the tumor. On the basis of the locations and radiographic characteristics, in common locations, imaging findings are characteristics and they may provide definite diagnosis, but in rare locations the radiological findings are not characteristics, and should be differentiating from other head and neck lesions.
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    ABSTRACT: A case of cauda equina paraganglioma is described; subsequent intracranial and intraspinal metastases occurred after partial resection and adjunctive radiotherapy. Cerebrospinal fluid dissemination is a rare complication of spinal paragangliomas. Factors predictive of this unusual biological behaviour are discussed.
    Acta Neurochirurgica 02/1996; 138(4):475-9. DOI:10.1007/BF01420312 · 1.79 Impact Factor
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