RESUMO
N/A.
Assuntos
Ecocardiografia Transesofagiana , Neoplasias Cardíacas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Imagem Multimodal/métodos , Paraganglioma Extrassuprarrenal/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Paraganglioma Extrassuprarrenal/patologia , Paraganglioma Extrassuprarrenal/cirurgia , Valor Preditivo dos TestesRESUMO
OBJECTIVE: To present our experience of 10 patients with extra-adrenal retroperitoneal paragangliomas, and assess prognostic tests. DESIGN: Retrospective study of casenotes. SETTING: University hospital, Italy. SUBJECTS: 10 Patients who presented with paragangliomas between 1970 and 1991. MAIN OUTCOME MEASURES: Histological and immunohistochemical results, and outcome. RESULTS: All tumours were completely resected and there was no operative mortality. Of the 8 patients who had no metastases at presentation 3 died of recurrence 3, 5, and 10 years later, respectively; 4 were alive and free of disease 2-7 years after diagnosis. The 2 patients with synchronous bone metastases at presentation died 1 and 4 years later. Immunohistochemical analysis of type I cells (chromogranin A and neurone-specific enolase) showed little correlation with progression of disease, but there was a correlation between the presence of type II cells (S100 protein) and good prognosis. CONCLUSIONS: Excision is the treatment of choice for paraganglioma. Immunohistochemical techniques may provide useful information about prognosis, in particular about those patients who are at increased risk of recurrence. Long term follow up is essential, because successful management of recurrence is dependent on early recognition.
Assuntos
Paraganglioma Extrassuprarrenal/cirurgia , Neoplasias Retroperitoneais/cirurgia , Adulto , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/secundário , Cromogranina A , Cromograninas/metabolismo , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Paraganglioma Extrassuprarrenal/diagnóstico , Paraganglioma Extrassuprarrenal/metabolismo , Paraganglioma Extrassuprarrenal/mortalidade , Paraganglioma Extrassuprarrenal/secundário , Fosfopiruvato Hidratase/metabolismo , Complicações Pós-Operatórias/mortalidade , Prognóstico , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/metabolismo , Neoplasias Retroperitoneais/mortalidade , Estudos Retrospectivos , Proteínas S100/metabolismo , Procedimentos Cirúrgicos Operatórios/métodos , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
The clinical and pathologic findings in eleven cases of parapharyngeal space tumors are described. The anatomy of this area and diagnostic procedures are discussed. Investigations should include a few basic examinations such as sialogram-computed tomographic (CT) scan, carotid angiogram, and echography. Several surgical approaches are considered in relation to the site and the size of the neoplasm. Prognosis depends on the histologic type of the tumor.