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

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.

[Cancerization of first branchial cleft cyst in the parotid gland: one case report].

A rare case of branchiogenic carcinoma from first cleft branchial cyst in the parotid gland is reported. An elderly male patient was admitted to the hospital presented with a mass accompanying with swelling and pain in the right parotid area for 5 days. Total right parotidectomy including the tumor resection and selective neck dissection were performed under general anesthesia. A thick-walled cyst containing necrotic tissue in the parotid gland was found. Postoperative histopathology showed that the tumor contained squamous epithelium and pseudostratified columnar epithelium. The cyst epithelium had atypical hyperplasia with necrosis. Some areas were cancerous with the formation of well-differentiated squamous cell carcinoma and cancer infiltration. No metastasis was found in the cervical lymph nodes. This case was in accordance with the diagnostic criteria of cancerization of the first branchial cleft cyst.