Summary
The aim of this article is to discuss clinical presentation, diagnostics and management of head and neck para gangliomas by reviewing literature and presenting a clinical case.
Introduction. Paragangliomas are rare, slow-growing, hypervascular tumors, which are of neural crest origin. Head and neck paragangliomas make up only 3% of all extraadrenal paragangliomas. 30–40% of all paragangliomas are hereditary with the most common genetic muta tions found in the Succinate Dehydrogenase fam ily. Head and neck paragangliomas usually occur as asymptomatic, slow-growing masses in the neck.
Case presentation. A 37-year-old woman presented with a lump on the right side of the neck. Ultrasonography showed 2 thyroid nodules and an inhomogenous mass similar to thyroid tissue on the right side of the neck next to the submandibular gland. Fine-needle aspiration biopsy of the thyroid nodule with the ultrasonographic signs of malignancy was per formed and histopathological assessment showed suspicion of malignancy, possibly papillary carcinoma. Fine- needle aspiration of the mass was performed sev eral times, but cytological evaluation was always in conclusive. On suspicion of thyroid papillary carcinoma, interpreting the mass as lymph node metastasis, total thyroidectomy with selective neck dissection was completed. Histology of surgical tissues confirmed papillary carcinoma diagnosis and re vealed that the mass in right submandibular area was well differentiated extra - adrenal paraganglioma.
Conclusions. There are plenty of imaging techniques to diagnose paraganglioma, it can be visualized with an easily accessible diagnostic test – ultrasonography. However, diagnostics of these tumors isn’t always that simple, asseen in our case.
