Paragangliomas tumors (sometimes referred to as glomus, as glomus cells are the place of origin) are a typically benign abnormal cell growth. Their cure is usually successful if completely removed by surgery; however, some cases do prove to be malignant.
Also known as chemodectomas, paragangliomas are usually single tumors that develop within the thorax, head, and neck, and in some instances, the lungs, thyroid gland, larynx, thoracic inlet, sinuses or nasal cavity.
Though doctors are not certain of the cause of these tumors, they are generally attributed to changes in the body’s homeostasis. Oxygen deprivation and remaining at high altitudes for a lengthy time period may increase the risk of developing paragangliomas. Multiple tumors, on the other hand, result from inherited genetic mutations.
Signs and Symptoms (Pathophysiology)
Depending upon where the tumor is located, as well as how large it is, there can be various symptoms present. Tumors affecting the head and neck can cause pain, nerve paralysis, and even some hemorrhaging or inflammation. Hearing loss, and other symptoms of the ear such as discharge, pain and vertigo, can also result.
Larger tumors can produce facial numbness, problems with shoulder movement, double vision, and weakness or paralysis of the tongue. Other symptoms may include eye and vocal problems, issues with swallowing, headaches, high blood pressure, anxiety, heavy sweating and palpitations.
Diagnosis and Staging
Imaging techniques, such as MRI and CT scans, are used to diagnose paragangliomas. Angiograms may also be used to confirm the diagnosis; tumors within the ear are able to be seen behind the eardrum and are often diagnosed through a physical exam.
Treatment
Curing paragangliomas is through straightforward, complete surgery. Nonsurgical procedures, such as embolization and radiation therapy, are available for some cases; while radiation does not eliminate the tumors, it does slow their growth. An endoscopic endonasal procedure, which involves minimal surgery, may be performed if tumors exist at the base of the skull. During treatment, some patients may experience crisis due to the release of hormones from paraganglioma secretions.
Outlook (Prognosis)
As paragangliomas grow very slowly and are normally benign, survival rate is very high. 94% of patients are still surviving twenty years post-treatment; 77% of those survivors also remain free of symptoms. Mortality rate overall is just over 8%.
