• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.149-152
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• 2012

Paraganglioma of the thyroid is a neuroendocrine tumor originating from the neural crest. To our knowledge, only 32 cases of thyroid paraganglioma(TP) have been reported to date. TP is difficult to distinguish from medullary thyroid cancer(MTC), hence correct diagnosis is seldom obtained preoperatively. Although immunohistochemistry is helpful for confirmation of TP, these markers are not specific for differential diagnosis between TP and MTC. Therefore, an index of suspicion is important when encountered with MTC with unusual features, or given pathology with neuroendocrine features and unusual immunohistochemical findings. The authors report a case of TP misdiagnosed as MTC at preoperative work-up and intraoperative frozen section analysis, with a review of the literature. The case depicts various immunohistochemical characteristics of the tumor.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.80-83
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• 2011

Paraganglioma is a relatively rare, generally benign and slow growing tumor arising from widely distributed paraganglionic tissue thought to originate from the neural crest. In the head and neck region, paraganglionic tissue is distributed in the superior and inferior paraganglia such as the carotid body, the vagal body, and the jugulotympanic region. Approximately 10% of patients with paraganglioma have a family history of such tumors. Multiple lesions can be found in 26% of patients with family history. It is important to distinguish between paraganglioma and atypical carcinoid tumor and medullary thyroid cancer. This can be done with histopathologic evaluation and immunohistochemical markers. Complete excision is recommended for the treatment of this tumor. Paraganglioma is particularly aggressive and rapid recurrence of paraganglioma is common after local resection. We present a case of malignant paraganglioma in the neck which recurred 2 months after local resection. We suppose that radiation therpay could be the last option for the treatment in this clinical setting.

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.5-13
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• 1989

Carotid body paraganglioma is uncommon, with appoximately 900 reports of it in the world literature, and with only 7 documented cases in the Korean literature. The classic carotid body paraganglioma develops in the bifurcation of common carotid artery and involves both the internal and external carotid arteries at it expands. The diagnosis may almost always be established preoperatively by selective angiography which shows a widening of the carotid bifurcation with a well defined vascular mass. Differential consideration of a single, lateral cervical mass in this location include branchial cleft cyst, neurogenic tumor, metastatic thyroid cancer, carotid body aneurysm and salivary gland tumor. Surgical therapy is the preferred method of treatment as these tumors are regarded as radioresistant. Because of their high vascularity and anatomical location, surgical removal of these tumors reguires a considerable degree of caution and a high degree of surgical expertise. With improved diagnostic and surgical technique, the morbidity and mortality has been reduced lately. This report details the management of 3 patients with carotid body paraganglioma who underwent safe resection by subadventitial dissection or using an internal vascular shunt.

• The Korean Journal of Cytopathology
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• v.4 no.1
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• pp.77-80
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• 1993

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was $3\times3cm$ in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells haying abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.94-99
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• 2005

Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

• The Korean Journal of Cytopathology
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• v.14 no.1
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• pp.7-11
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• 2003

Hyalinizing trabecular adenoma of the thyroid gland is a rare benign neoplasm predominantly diagnosed in middle-aged women. Carney et al. first described this entity that may mimic paraganglioma, medullary carcinoma and papillary carcinoma in 1987. We describe cytologic and histopathologic features of a case of hyalinizing trabecular adenoma combined with occult papillary carcinoma in the opposite lobe. A 55-year-old woman presented with nontender palpable mass of the right neck for 6 months. The aspirate was cellular and contained small clusters and sheets of epithelial cells with abundant filamentous, vacuolated, and ill-defined cytoplasm. The nuclei were slightly pleomorphic and showed nuclear overlapping, nuclear grooves, and intranuclear cytoplasmic inclusions. Histologic examination showed hyalinizing trabecular adenoma in the right lobe and occult papillary carcinoma in the left lobe.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.516-523
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• 1996

The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.