Paraganglioma involving the larynx

Area of Science:

• Head and Neck Surgery
• Oncology
• Pathology

Background:

• Paragangliomas are rare neuroendocrine tumors, with laryngeal and tracheal locations being exceptionally uncommon.
• The classic 'Zellballen' architecture is a key histopathological feature.
• Differential diagnosis often includes hemangiopericytoma.

Observation:

• A 44-year-old woman presented with a dumbbell-shaped tumor involving the subglottic larynx and extending into the left thyroid lobe.
• The tumor's location suggested origin from the inferior laryngeal paraganglia.
• Preoperative diagnosis was hemangiopericytoma.

Findings:

• Histopathological examination confirmed paraganglioma with characteristic organoid nesting ('Zellballen').
• Electron microscopy revealed neurosecretory granules.
• Angiography was considered a valuable diagnostic tool.

Implications:

• Surgical resection, including laryngectomy and thyroid lobectomy, achieved a favorable outcome.
• Complete resection led to no local recurrence or distant metastases at 7-year follow-up.
• This case highlights the importance of considering paraganglioma in the differential diagnosis of neck masses.