Pitfalls in the management of subglottic paragangliomas at unusual location: a case report and literature review

BMC Surg. 2021 Sep 8;21(1):340. doi: 10.1186/s12893-021-01337-6.

Abstract

Background: Subglottic paragangliomas (PGs) are exceptionally rare and unpredictable, occasionally presenting at an atypical location. There are three different clinical forms of subglottic PGs: intraluminal (tracheal PGs), extraluminal (thyroid PGs) and the mixed type (both intraluminal and extraluminal, mixed-subglottic PGs). These tumors are usually misdiagnosed as other relatively common primary thyroid or laryngotracheal tumors, and the treatment is troublesome.

Case presentation: A 22-year-old male patient with subglottic PGs has been successively misdiagnosed as thyroid tumors and subglottic hemangiomas, and lastly underwent local extended lumpectomy and laryngotracheal reconstruction with a pedicled thoracoacromial artery perforator flap (PTAPF). The patient was decannulated successfully after the second-stage tracheal reconstruction with a local flap, and no evidence of local recurrence and distant metastasis of the tumor until now.

Conclusion: Subglottic PGs can be easily misdiagnosed as laryngotracheal or thyroid tumors when presented at an atypical location. It is essential for otolaryngologists and head and neck surgeons to remain vigilant against these tumors. If the tumor is not diagnosed or removed completely, patients may encounter a risk of lethal paroxysm, which is incredibly troublesome.

Keywords: Case report; Laryngeal paraganglioma; Subglottic paraganglioma; Thyroid paraganglioma; Tracheal paraganglioma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Humans
  • Laryngeal Neoplasms* / diagnosis
  • Laryngeal Neoplasms* / surgery
  • Male
  • Neoplasm Recurrence, Local
  • Paraganglioma* / diagnosis
  • Paraganglioma* / surgery
  • Plastic Surgery Procedures*
  • Thyroid Neoplasms* / surgery
  • Young Adult