Paraganglioma of the nasal cavity. case report

  • Mykola Popov Full Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University https://orcid.org/0000-0002-5759-9654
  • Olena Ognivenko Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University https://orcid.org/0000-0003-3936-0305
  • Olena Lisovets doctor - ENT specialist, Director of the ENT Center «V. T. Lisovets Dynasty»
  • Olga Sorokina Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University
  • Vera Olenych Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University https://orcid.org/0000-0002-4776-1486
Keywords: paraganglioma, nasal cavity, diagnosis, treatment

Abstract

Paraganglioma is one of the tumors that is rarely found in the practice of an otorhinolaryngologist. Approximately 90% of tumors from nonchromaffin paraganglia occur in the adrenal glands. Nevertheless, 5 – 10 % of paragangliomas have different localization: 85 % - in the abdominal cavity, 12 % - in the chest, 3 % - on the head and neck. Paraganglioma grows slowly, but there is a risk of its degeneration into a malignant neoplasm. Diagnosis of paraganglioma includes CT, MRI; Ultrasound scintigraphy, arteriography, biopsy, histological examination. The main treatment for this education is surgical. As this tumor occurs rather rarely, we present a clinical observation of a paraganglioma of the nasal cavity.

Purposes. The purpose of this article is to describe a rare clinical case of paraganglioma of the nasal cavity to determine diagnostic measures and treatment tactics to help a practical doctor.

Materials and methods. On 01/18/2019 patient M., 52 years old, with complaints of recurrent nosebleeds, difficulty breathing in the right half of the nose was received at the ENT Center «V. T. Lisovets Dynasty». Bleeding from the nasal cavity has been disturbing the patient twice a week for 6 months, for no apparent reason. An increase in the frequency of bleeding up to 4–5 times a week has been noticed for the last month. On a series of MRI tomograms dated 12.24.2019, in the front sections of the nasal concha, on the right, a volumetric pathological formation with dimensions of about 10 × 12 mm, with tuberous contours, an inhomogeneous MR structure was determined. Bone structures were not affected. The neoplasm narrowed the lumen of the nasal cavity on the right. Conclusion: MR-picture of the pathological volumetric formation (of blastomatous nature) of the nasal cavity on the right.

Results. On 01/21/2019 the patient underwent surgical removal of the neoplasm within healthy tissues using a radioknife. An anterior nasal tamponade with a hemostatic preparation was performed. The postoperative period was without complications. A morphological examination of surgical material N 330/2019 yielded the following results: a microscopic examination determined a tumor with the same histological picture in the form of alveolar and solid areas, a branched network of blood vessels of capillary type, fibrous tissue of various thicknesses. Tumor parenchyma was represented by epithelioid morphology cells with pronounced eosinophilic cytoplasm, a large nucleus with granular chromatin. Cells with a weakly expressed eosinophilic cytoplasm, with small monomorphic nuclei were also found.

Conclusions. The patient was diagnosed with a rare tumor of neuroectodermal nature, which in most cases has a benign nature, slow growth and develops from nonchromaffin ganglia, which are scattered throughout the body. As the formation grows, the arterial and venous network of vessels develops. The clinical picture of a neoplasm of the nasal cavity is often masked by the symptoms of chronic polypousrhinosinusitis, vasomotor and chronic hypertrophic rhinitis.

Based on the foregoing, this clinical cases valuable for the practitioner in terms of the features of localization, diagnosis and these lection of the correct therapy for this category of patients.

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Author Biographies

Mykola Popov, Full Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University

6, Svobody sq., Kharkiv, Ukraine, 06122

Olena Ognivenko, Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University

6, Svobody sq., Kharkiv, Ukraine, 61022

Olena Lisovets, doctor - ENT specialist, Director of the ENT Center «V. T. Lisovets Dynasty»

19-a, Mironositskaya str., Kharkov, Ukraine, 61022

Olga Sorokina, Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University

6, Svobody sq., Kharkov, Ukraine, 61022

Vera Olenych, Candidate of Medicine, Associate Professor, Department of General and Clinical Immunology and Allergology, School of Medicine, V. N. Karazin Kharkiv National University

6 Svobody sq., Kharkov, Ukraine, 61022

References

Khasanov, R. A., Azizyan, R. A., Ungiadzeetal, G. V. (2016). Paraganglioma of the larynx. Description of clinical observation. Tumors of the head and neck, 6, 67–70. doi:10/17650/2222-1468-2016-6-6-67-70.

Kushnir, G. M., Ioshina, M. M., Savchuk, E. A., Miklyaev A. A. (2012). Carotid chemodectoma: a clinical case with a favorable outcome after resection of the common carotid artery. International Neurological Journal, 5 (51), 72–75.

Alferova, Yu. S., Surin, V. D., Karpov, N. V. (2017). Current concept of a carotid chemodectome and the effectiveness of methods of its treatment. Kazan Medical Journal, 98(5), 792–796. doi: 10/17750/KMJ2017-792 /.

Carroll, W., Stenson, K., Stringer, S. (2004). Malignant carotid body tumor. Head Neck, 26(3), 301–306. doi:10.1002/hed.20017.

Zabel, A., Milker-Zabel, S., Huber, P., Schulz-Ertner, D., Schlegel, W., Wannenmacher, М., Debus, J. (2004). Fractionated stereotactic conformal radiotherapy in the management of large chemodectomas of the skull base. Int. J. Radiat. Oncol. Biol. Phys, 5, 1445-1450. doi:10.1016/j.ijrobp.2003.09.070.

Mitin Yu.V. (1968). Primary radiation of tympanoyugularparagangiloma. Bulletin of otorhinolar, 2, 109–110.

Ketabchi, S., Massi, D., Santoro, R., Franchi, A. (2003). Paraganglioma of the nasal cavity: a case report. Eur Arch Otorhinolaryngol, 260, 336–340. doi: 10.1007/s00405-002-0569-4.

Granato, L., Donato Próspero, J., Martini Filho, D. (2013). Nasal paraganglioma: A case report and literature review. Int Arch Otorinolaryngol, 17(1), 92–95. doi:10.7162/S1809-97772013000100016.

Nguyen, Q. A., Gibbs, P. M., Rice, D. H. (1995). Malignant nasal paraganglioma: a case report and review of the literature. Otolaryngol Head Neck Surg, 113, 157–61.

Bezhanova, S. D., Khasanov, R. A., Pavlovskaya, A. I., Smirnova, E. A. (2017). Paraganglioma of the larynx. Archive of Pathology, 79(5), 34–37. doi: 10.17116/patol201779534-37

Published
2020-09-08
How to Cite
Popov, M., Ognivenko, O., Lisovets, O., Sorokina, O., & Olenych, V. (2020). Paraganglioma of the nasal cavity. case report. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (39), 106-110. https://doi.org/10.26565/2313-6693-2020-39-12