Feasibility of a wait-and-scan period as initial management strategy for head and neck paraganglioma

Head Neck. 2017 Oct;39(10):2088-2094. doi: 10.1002/hed.24871. Epub 2017 Jul 10.

Abstract

Background: The main goal of head and neck paraganglioma (PGL) management is reduction of treatment-induced and tumor-induced complications. In the current study, tumor growth rates and tumor-induced complications during a wait-and-scan period are evaluated.

Methods: This was a retrospective cohort study. Tumor growth was measured in axial plane diameter and tumor volume.

Results: Of 59 jugulotympanic tumors, 71 carotid body tumors, and 29 vagal body tumors, 44% were growing (median follow-up of 63.6 months). Median growth rates were 0.41 mm/year (range 0-439 mm), 1.6 mm/year (range 0-23.68 mm), and 1.6 mm/year (range 0-23.68 mm) respectively. Growth was significantly correlated to age at presentation (odds ratio [OR] = 0.974; P < .05). Seventeen tumors induced 20 complications. Six of these tumors were growing, and growth rates were higher than in tumors not inducing complications (P = .016; F = 6.496).

Conclusion: These results illustrate the feasibility of a wait-and-scan strategy for head and neck PGL. The management strategy could not prevent tumor-induced complications in 16% of nongrowing tumors.

Keywords: management; paraganglioma; wait-and-scan.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Mutation
  • Paraganglioma / complications
  • Paraganglioma / pathology*
  • Paraganglioma / therapy
  • Retrospective Studies
  • Succinate Dehydrogenase / genetics
  • Watchful Waiting / methods*
  • Young Adult

Substances

  • Succinate Dehydrogenase