Paragangliomas of the neck: clinical and pathologic analysis of 116 cases

Neck tumors developing from the paraganglion system are best called paragangliomas. They may be described further as to site of origin and as to whether they are functioning or nonfunctioning. Review was made of 116 cases in which operation for paraganglioma was performed at the Mayo Clinic. The diagnosis depends upon demonstration of a lateral neck mass, elimination of other causes, and a tumor blush on angiography. Screening tests should be done to determine whether the tumor is producing epinephrine. Surgical management should be selective, depending upon the location and involvement of surrounding structures, particularly the carotid artery system. A conservative approach is indicated for those patients whose tumor surrounds the carotid vessels, because the risk of complications is greater than the risk of leaving the tumor in the neck. Conservatism is also indicated for patients in the older age group, because of the slow growth of these tumors and the low incidence of malignancy.