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[Asymptomatic bladder paraganglioma. Report of a case].

Paragangliomas are tumors which arise from collections of neuroepithelial cells (paraganglion system) scattered throughout the body and rarely in the urinary bladder. In this work, we described a case of bladder paraganglioma, not suspected in a 64-year-old male who showed occasional total hematuria as only symptom. Cystoscopically, it was diagnosed as a rounded, not papillary tumor, one centimeter in diameter on account of which it was subjected to TUR. Confirmed the diagnosis, a partial cystectomy and a limited regional lymphadenectomy were subsequently practised. Posterior evolution, after a year, was completely favourable. The main clinicopathologic characteristics of this entity are revised.

Humans↗

Primary paraganglioma of the facial nerve canal.

We report two cases of primary paraganglioma of the facial nerve canal. This entity should be considered in patients presenting with facial paresis or pulsatile tinnitus. Paraganglioma should be considered when a lesion appears to arise from the facial nerve canal.

Aged↗

[Malignant paraganglioma with intracranial metastasis: a case report].

We report a case of malignant paraganglioma with intracranial metastasis. A 26-year-old man presented with leg pain. On admission a metastatic bone tumor was found. General examination revealed metastatic lesions in the lung, liver, orbits, ethmoid sinus, anterior mediastinum, and brain. An MRI of the head showed multiple lesions in the skull bone and intracranial space. A biopsy was performed on the right temporal tumor, resulting in a diagnosis of malignant paraganglioma. The tumor origin could not be determined. The tumor resection was not indicated because of multiple metastasis. Both chemotherapy and radiotherapy were given to the patient, but a satisfactory outcome was not obtained.

Adult↗

[A case of paraganglioma of urinary bladder in a 96-year-old female].

A 96-year-old woman was referred to our hospital with gross hematuria. Cystoscopy, computed tomography and magnetic resonance imaging revealed a submucosal bladder tumor. Incomplete transurethral resection was performed with no intraoperative complications. The histopathological diagnosis of nonmalignant paraganglioma was confirmed by immunohistochemical staining. This patient is the oldest of the 49 patients with paraganglioma of the urinary bladder reported in the Japanese literature.

Aged↗

[Bladder paraganglioma. Report of a case and review of the Spanish literature].

Paragangliomas are rare tumours of the bladder accounting for 0.06% of all vesical tumours. This paper reports one case of vesical paraganglioma in a young female patient that has the singularity of being associated to melanin pigmentation. A review is made of cases treated in Spain, adding some comments on the signs and symptoms presented, as well as the diagnostic and therapeutical methods used in this unusual condition.

Adolescent↗

Low-grade adenocarcinoma of endolymphatic sac mimicking jugular paraganglioma at clinical and neuroradiological examination.

We report a case of low-grade adenocarcinoma of endolymphatic sac origin mimicking jugular paraganglioma at clinical and neuroradiological examination. The lesion occurred in a 72-year-old male who presented with a long-standing history of right-sided hearing loss and a few-week history of progressive facial nerve palsy and right aural pain. At histology, the tumor was composed of pseudoglandular spaces with papillary infoldings. Lumina contained colloid-like material. The lesion was surgically removed with suboccipital approach following endoarterial embolization. This study emphasizes that low-grade adenocarcinomas of endolymphatic sac origin extending to posterior cranial fossa and jugular paraganglioma may be indistinguishable preoperatively at clinical and radiological levels.

Adenocarcinoma↗

[Paraganglioma of the cauda equina. Apropos of a case with review of the literature].

Paragangliomas are unusual neuroendocrine tumors. The most common anatomical site is within head and neck (90%). It has rarely been described in the region of the cauda equina. We report the case of a 49 years-old white woman who presented with a slow, progressive cauda equina syndrome over a 20-years period. Radiological examination showed erosion of the vertebral laminae of L4, L5 and S1 and disclosed an intra-dural mass lesion occupying the entire spinal canal between L4 and S1. The patient underwent sub-total excision and adjuvant radiation therapy. Histological examination concluded to a paraganglioma. This diagnosis was confirmed by immunohistochemical studies.

Cauda Equina↗

Paraganglioma of the cauda equina: MR findings. One case.

Paraganglioma of the filum terminale is a rare tumor but well described in the neurosurgery and pathology literature. Few MRI reports are mentioned. Paraganglioma, often misdiagnosed with ependymoma or schwannoma on MRI images, must be kept in mind, when a highly vascular lesion with serpentine vessels is observed.

Adult↗

[Paraganglioma in the case records of the III Surgical Clinical Institute].

Cervical paragangliomas are uncommon benign or malignant neoplasms, originated from the stem cells of the neural crest. Up to date it is still not easy to define properly their biological behaviour, the possible multicentric location and the association with Multiple Endocrine Neoplasias. After a wide review of recent diagnostic, pathological and clinical notions, the Authors report their experience, from 1970 to 1995, of 10 patients affected by sporadic paraganglioma and 1 by familial multicentric neoplasm localized on carotid bodies of both sides, left vagus nerve and left hypoglossus nerve. All patients but one were treated by a curative resection of the neoplasm; in one case only an explorative laparotomy was possible because of the visceral and vascular involvement.

Adult↗

[Retroperitoneal paraganglioma. Differential diagnosis with hypernephroma].

Paraganglioma are tumours that show embryological origin from the neural crest, and which derive from the paraganglia. They can be found in any location throughout the aorta and/or in association to the sympathetic chain. They can be either functioning or non-functioning based on hormone production. The authors present here a non-functioning retroperitoneal paraganglioma as an incidental finding in a 72-year old female patient. Pre-operative diagnosis was cystic hypernephroma, for which radical nephrectomy was performed. The extra-renal origin of the tumour was found subsequently on examining the piece. A discussion is included on the diagnosis, treatment, prognosis as well as a review of the literature.

Aged↗

[Thyroid paraganglioma: report of a case].

A case of thyroid gland paraganglioma is reported in a 48-year-old woman with cold thyroid nodule. Review of the literature reveals only 4 cases of intrathyroidal paraganglioma but none of them have complete immunohistochemical study. The main differential diagnosis in this localization, namely medullary carcinoma and trabecular hyalinizing adenoma, are discussed.

Female↗

Paraganglioma of the cauda equina: a case presenting features of increased intracranial pressure.

Paragangliomas are benign tumors arising from the heterotopic sympathetic ganglion. They occur more often in the carotid body, glomus jugulare, mediastinum, and paraaortic region; central nervous system locations include the petrous ridge, pineal region, and sella turcica. We report the clinical and imaging features of an unusual case of paraganglioma of the cauda equina. Magnetic resonance imaging (MRI) of the thoracolumbar region should be performed in cases of increased intracranial pressure whenever the head examination does not reveal the exact cause of the problem.

Cauda Equina↗

[Secreting retroperitoneal paraganglioma. Apropos of a case].

A case of secreting, asymptomatic retroperitoneal paraganglioma is presented. Paragangliomas are rare neuroendocrine tumors and the malignant behaviour, higher than pheochromocytomas, is based on metastases or local recurrence. The treatment is complete surgical excision. Radiotherapy and chemotherapy may be used for palliation of symptoms.

Chemotherapy, Adjuvant↗

Fine-needle aspiration of six carotid body paragangliomas.

We report six carotid body paragangliomas diagnosed by fine-needle aspiration (FNA) in five patients. A total of eight aspirations were performed. The cytologic findings are characteristic: hemorrhagic background, hypo- to hypercellular smears (depending on the skill of the aspirator) with cells having delicate, ill-defined, vacuolated cytoplasm, pleomorphic nuclei with distinct nucleoli, rare intranuclear cytoplasmic inclusions, and prominent rosette formation. No complications arose in any of the eight aspirations. FNA is a safe, accurate means of diagnosing carotid body paragangliomas. It can provide essential information for treatment planning and patient management.

Adult↗

Novel mutations in the SDHD gene in pedigrees with familial carotid body paraganglioma and sensorineural hearing loss.

Paraganglioma (PGL) is a rare disorder characterized by tumors of the head and neck region. Between 10% and 50% of cases of PGL are familial, and the disease is autosomal dominant and subject to age-dependent penetrance and imprinting. The paraganglioma gene (PGL1) has been mapped to 11q22.3-q23, and recently germline mutations in the SDHD gene have been identified. The SDHD region contains another gene, DPP2/TIMM8B, the homolog of which causes dystonia and deafness seen in Mohr-Tranebjaerg syndrome. Using four PGL pedigrees, two of which exhibit coinheritance of PGL and sensorineural hearing loss or tinnitus, analysis of 14 microsatellite markers provided support for linkage to the PGL1 locus. Sequence analysis identified novel mutations in exon 1 and exon 3 of the SDHD gene, including a novel two base pair deletion in exon 3 creating a premature stop codon at position 67; a novel three base pair deletion in exon 3 resulting in the loss of Tyr-93; a missense mutation in exon 3 resulting in the substitution of Leu-81 for Pro-81; and a novel G-to-C substitution in exon 1 resulting in the substitution of Met-1 for Ile-1. No base changes were detected in the DPP2/TIMM8B gene. There was no apparent loss of heterozygosity at the site of the SDHD mutations. However, RT-PCR analysis of tumor samples showed monoallelic expression of the mutant (paternal) allele as expected for imprinting. This has not previously been shown for this disorder. The inheritance and expression of the SDHD gene is consistent with the PGL1 gene being subject to genomic imprinting.

Adolescent↗

Dynamic contrast enhancement of paragangliomas of the head and neck: evaluation with time-resolved 2D MR projection angiography.

Our objective was to evaluate tumor hemodynamics of paragangliomas of the head and neck. A 2D magnetic resonance projection angiography (MRPA) protocol was developed. Six patients with histologically proven paragangliomas were included in the study. The sequence protocol and data post-processing procedure were optimized in view of a high temporal resolution and maximum contrast-to-noise ratio. Image-time series of two freely orientated slabs could be obtained. Correlation analysis was performed to generate selective arterial and venous weighted angiographic images. Glomus tumors showed a rapid and intense homogeneous enhancement following the intravenous administration of contrast material. The smallest tumors investigated measured 10 mm and could be visualized clearly. Time-resolved analysis of the tumor enhancement revealed an early bolus arrival within the vascular bed of the tumor and prolonged incomplete washout indicating blood pooling. The dynamic contrast enhancement of glomus tumors can be evaluated non-invasively with MRPA providing a high temporal resolution and high image quality. The characteristic contrast enhancement of glomus tumors can be helpful in the diagnostic workup of lesions that may mimic glomus tumors.

Carotid Body Tumor↗

Autosomal dominant malignant and catecholamine-producing paraganglioma caused by a splice donor site mutation in SDHC.

Mutations in SDHC cause autosomal dominant paraganglioma, type 3 (PGL3), and have to date been demonstrated in only one family. Here, we report on a novel mutation in a patient with a malignant, catecholamine-producing paraganglioma at the carotid bifurcation. The mutation is a G-->T transversion at position +1 of intron 5 of the SDHC gene, leading to the deletion of exon 5 and a shift in the reading frame.

Adult↗

Paraganglioma (pheochromocytoma) of the posterior mediastinum: a case report and review of the literature.

Pheochromocytoma is an uncommon tumor in the pediatric population. Paraganglioma, or extra-adrenal pheochromocytoma, accounts for only a small fraction of pediatric pheochromocytomas, with most of these tumors presenting within the abdominal cavity. Herein the authors report the extremely rare case of a biochemically active paraganglioma presenting as a posterior mediastinal mass in an 8-year-old boy.

Child↗