Paragangliomas of the Sellar Region
Department of Neurological Surgery, University of Washington Medical Center, Seattle. Neurosurgery
(Impact Factor: 3.62).
06/1993; 32(5):844-7. DOI: 10.1097/00006123-199305000-00021
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.
Available from: Faiz Ahmad
- "GAD enhancement Bilaterally fed by multiple arteries; tumor blush Sambaziotis et al. (1998) 10 Intense enhancement – Scheithauer et al. (1995) 8 Contrast enhancing ⁄ . Inhomogeneous enhancing mass, high T2-weighted signal Highly vascular; vascular blush Steel et al. (1993) 13 Isointense T1-weighted and uniformly contrast enhancing with GAD No vascular blush Flint et al. (1993) "
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ABSTRACT: It is extremely rare for paragangliomas to be present in the brain. We present a 44-year-old man with a suprasellar-sellar paraganglioma encasing the internal carotid arteries. We review all such tumors reported in the literature and conclude that paraganglioma should be kept in the differential diagnosis of unusual suprasellar-sellar lesions.
- "The former distinction into chromaffin and non-chromaffin paragangliomas has been abandoned since the reaction of tumor cells with chromic acid does not reliably reflect their functional activity, i.e., catecholamine secretion. The fact that the tumor cells arise from paraganglionic cells explains, and also indicates, their site and origin. More than 90% of paragangliomas in the cranial cavity occur in the jugular foramen. "
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ABSTRACT: Paragangliomas are rare, usually benign tumors of neural crest origin. They account for only 0.6% of all head and neck tumors. In the craniocervical area, they are more common in the carotid body and tympanico-jugular regions. To the authors' knowledge, a case of paraganglioma in Meckel's cave has not yet been reported in the medical literature. The pathogenesis and natural history of paragangliomas are still not well understood. We present a case of recurrent paraganglioma in Meckel's cave.
A 53-year-old woman was diagnosed with trigeminal neuralgia, dysesthesia and hypoesthesia on the left side of the face, hearing disturbance and a history of chronic, persistent temporal headaches. Magnetic resonance imaging (MRI) showed a lesion located in Meckel's cave on the left side, extending to the posterior cranial fossa and compressing the left cerebral peduncle. The lesion was first thought to be a recurrence of an atypical meningioma, as the pathologist described it in the tissue specimen resected 3 years earlier, and a decision for re-operation was made. A lateral suboccipital approach to the lesion was used under neuronavigational guidance. The tumor was removed, and histological examination proved the lesion to be a paraganglioma. Five months later, the follow-up MRI showed local regrowth, which required subsequent surgical intervention.
A paraganglioma in Meckel's cave is an uncommon tumor in this location. Although ectopic paragangliomas have been described in the literature, a paraganglioma atypically located in Meckel's cave makes a topographic correlation difficult, mainly because paraganglionic cells are usually not found in Meckel's cave. Another peculiarity of the case is the local recurrence of the tumor in a relatively short time despite an attempted, almost gross total resection.
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