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Head Neck. 2019 Jun 25. doi: 10.1002/hed.25849. [Epub ahead of print]

Second primary tumors in patients with a head and neck paraganglioma.

Author information

1
Cleveland Clinic, Head & Neck Institute, Cleveland, Ohio.
2
School of Medicine, Case Western Reserve University, Cleveland, Ohio.
3
Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio.
4
Department of Endocrine Surgery, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, Ohio.

Abstract

BACKGROUND:

There are conflicting recommendations and possibly overuse of imaging for surveillance of second primary tumors for patients with a history of head and neck paraganglioma.

METHODS:

Retrospective cohort study of 234 adults with head and neck paragangliomas (1990-2010) followed for a mean of 7.5 ± 8.4 years.

RESULTS:

The rate of second paraganglioma was 1.7% after 5 years and 5.1% after 10 years, yielding an incidence of 6.65 per 1000 person-years. Only 1.3% of patients (2.59 per 1000 person-years) ever had a second paraganglioma in the chest, abdomen, or pelvis. Patients with a hereditary paraganglioma (hazard ratio [HR] = 4.84, 95% confidence interval [CI]: 1.52-15.43) or carotid body tumor (HR = 3.55, 95% CI: 1.15-10.99) were at greater risk.

CONCLUSIONS:

The incidence rate of a second primary paragangliomas is low but increases with hereditary disease. These results question the utility of repeated imaging outside of the neck to screen for second paragangliomas.

KEYWORDS:

glomus tumor; imaging; paraganglioma; second primary tumor; surveillance

PMID:
31240818
DOI:
10.1002/hed.25849

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