From the Guidelines
Head and neck paragangliomas typically present with symptoms related to their location and mass effect on surrounding structures, including a painless, slow-growing neck mass or swelling, difficulty swallowing, voice changes, hearing loss, pulsatile tinnitus, and dizziness, as reported in the most recent study 1. The symptoms of head and neck paraganglioma can vary significantly depending on the specific location of the tumor.
- Common symptoms include:
- A painless, slow-growing neck mass or swelling that may be visible or palpable
- Difficulty swallowing (dysphagia)
- Voice changes or hoarseness
- Hearing loss
- Pulsatile tinnitus (ringing in the ears that coincides with heartbeat)
- Dizziness
- Some patients may develop cranial nerve deficits, resulting in symptoms like:
- Facial weakness
- Difficulty speaking
- Problems with tongue movement
- In rare cases (approximately 1-3%), these tumors are functional and secrete catecholamines, leading to symptoms such as:
- High blood pressure
- Headaches
- Sweating
- Palpitations
- Anxiety—similar to those seen in pheochromocytoma, as noted in 1. The symptoms often develop gradually as these tumors are typically slow-growing, and early diagnosis is important to prevent significant morbidity through local invasion of critical structures, although they rarely metastasize, as discussed in 1. Imaging studies are essential for proper diagnosis and treatment planning, as the symptoms vary significantly depending on the specific location of the paraganglioma, whether it's carotid body, jugular, vagal, or tympanic in origin. It is crucial to consider the potential for cranial nerve deficits and other sources of morbidity when managing head and neck paragangliomas, as highlighted in the recent clinical consensus guideline 1.
From the Research
Symptoms of Head and Neck Paraganglioma
The symptoms of head and neck paraganglioma can vary depending on the location and secretion of the tumor. Some common symptoms include:
- Headaches
- Palpitations
- Diaphoresis (excess sweating)
- Hypertension (high blood pressure)
- Tachycardia (rapid heart rate)
- Dysarthria (speech difficulties)
- Dysphagia (swallowing difficulties)
- Aspiration
- Hoarseness
Secretory Symptoms
Some paragangliomas can secrete catecholamines, leading to symptoms such as:
Non-Secretory Symptoms
Non-secretory paragangliomas can cause symptoms due to their location and size, such as:
Diagnosis and Management
Diagnosis of head and neck paraganglioma is made through a combination of biochemical testing, imaging modalities, and functional imaging. Management of the tumor depends on its pathology, location, and aggressiveness, and can range from observation to resection to systemic treatment 5, 3, 6