John M Del Gaudio1, Susan Muller. 1. Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, The Emory Clinic, 1365A Clifton Rd, NE, Atlanta, GA 30322, USA. john_delgaudio@emory.org
Abstract
BACKGROUND: Paragangliomas of the larynx are unusual tumors that are seen as a vascular submucosal mass. These usually are seen in the supraglottic larynx but have also been found in the subglottis. This is the only laryngeal neuroendocrine tumor with a female predilection. It is important that paragangliomas be differentiated from other neuroendocrine tumors of the larynx, including atypical carcinoid, because of differing treatment modalities. METHODS: We present the clinical, radiologic, and pathologic findings of a supraglottic laryngeal paraganglioma seen in a 50-year-old woman with a 6-month history of slowly progressive hoarseness. RESULTS: The tumor was successfully approached by means of a midline laryngofissure with mucosal preservation. The patient remains disease free 24 months after surgery. CONCLUSIONS: Preoperative CT and angiography are useful in making the diagnosis of paraganglioma before surgical intervention. Complete excision through an external mucosa-sparing approach is the treatment of choice. Distinguishing laryngeal paraganglioma from other neuroendocrine tumors can be difficult. Immunohistochemistry is an important tool for the correct pathologic diagnosis. Copyright 2004 Wiley Periodicals, Inc.
BACKGROUND:Paragangliomas of the larynx are unusual tumors that are seen as a vascular submucosal mass. These usually are seen in the supraglottic larynx but have also been found in the subglottis. This is the only laryngeal neuroendocrine tumor with a female predilection. It is important that paragangliomas be differentiated from other neuroendocrine tumors of the larynx, including atypical carcinoid, because of differing treatment modalities. METHODS: We present the clinical, radiologic, and pathologic findings of a supraglottic laryngeal paraganglioma seen in a 50-year-old woman with a 6-month history of slowly progressive hoarseness. RESULTS: The tumor was successfully approached by means of a midline laryngofissure with mucosal preservation. The patient remains disease free 24 months after surgery. CONCLUSIONS: Preoperative CT and angiography are useful in making the diagnosis of paraganglioma before surgical intervention. Complete excision through an external mucosa-sparing approach is the treatment of choice. Distinguishing laryngeal paraganglioma from other neuroendocrine tumors can be difficult. Immunohistochemistry is an important tool for the correct pathologic diagnosis. Copyright 2004 Wiley Periodicals, Inc.