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Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

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American Journal of Medicine Studies
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A Case of Non-functioning Paraganglioma – A Rare Phenomena

Obed Agyei, Zonera Ali, Yanmin Zhang*

Lankenau Medical Center, Wynnewood, PA USA

Abstract: Non-functioning paragangliomas are rare tumors. I describe a case of a 74-year-old woman who presented with worsening neck mass and subsequently discovered to have a non-functioning paraganglioma after surgical resection. These tumors are associated with paraneoplastic diseases including MEN Syndromes, Neurofibromatosis and Von Hippel Lindau. Patients should be referred for genetic counseling once diagnosis is established.

Keywords: Paraganglioma, rare, genetics, MEN syndrome

Received January 05, 2023; Revised February 11, 2023; Accepted February 19, 2023

Citation: Obed Agyei, Zonera Ali, Yanmin Zhang, A Case of Non-functioning Paraganglioma – A Rare Phenomena. American Journal of Medical Case Reports, 11 (2). 31-32. January 2023. doi:10.12691/ajmcr-11-2-6

1. Case Report

Introduction: Paragangliomas, also known as non-epithelial neuroendocrine tumors are rare. They are further characterized as sympathetic (functioning) or parasympathetic (non-functioning). It is estimated that the overall incidence is 0.66 cases per 100,000 people per year.

Case: 74-year-old female with history of multiple thyroid nodules presented with worsening swelling of her left neck. Ultrasound revealed hypervascular mass at the left carotid bifurcation. A follow up CT Neck with IV contrast showed 2 x 2.3 x 3.5 cm hyperenhancing mass. On admission, her vital signs were unremarkable, and she did not report of weight loss, diarrhea, constipation, chest pain, palpitation, flushing, episodic headache, chest pain or shortness of breath. She subsequently underwent carotid body tumor resection with final pathology revealing paraganglioma. Patient was subsequently referred to Genetics for further testing.

2. Conclusion and Discussion

Non-functioning paragangliomas are rare diseases. Most tumors are located in the head & neck mostly in the skull base at the distribution of the IX and X cranial nerves. Patients are typically asymptomatic and do not exhibit sequalae of pheochromocytoma. It has been reported that most paragangliomas are sporadic however 30% of all paragangliomas are hereditary including the paraganglioma syndromes 1, 3 and 4 subtypes. Other forms may be associated with multiple endocrine neoplasia 2A and 2B (MEN), neurofibromatosis 1 and Von Hippel Lindau (VHL) disease. A thorough History and Physical is of valuable importance however surgical biopsy and resection are warranted. Patients should be closely monitored for possible malignant transformation and associated MEN syndromes based on clinical suspicion. All patients with paragangliomas should be screened for germline mutations. Our patient was referred to the Genetic Counseling team for further assessment.

Figure A, B and C. 2 x 2.3 x 3.5 cm hyperenhancing mass splaying the LEFT carotid bifurcation

Figure D. 2X magnification; Figure E. 10X magnification; Figure F. AE1/AE3 staining; Figure G. CD56 staining; Figure H. Chromogranin staining; Figure I. Synaptophysin staining

References

[1]   | Mete O; Asa SL; Gill AJ; Kimura N; de Krijger RR; Tischler A; (n.d.). Overview of the 2022 who classification of Paragangliomas and Pheochromocytomas. Endocrine pathology. Retrieved October 1, 2022, from https://pubmed.ncbi.nlm.nih.gov/35285002/.
[2]   | Ikram A, Rehman A. Paraganglioma. 2022 Jun 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 31751024.

[3]  
Leung, A. A., Pasieka, J. L., Hyrcza, M. D., Pacaud, D., Dong, Y., Boyd, J. M., Sadrzadeh, H., & Kline, G. A. (2021, January 1). Epidemiology of pheochromocytoma and paraganglioma: Population-based Cohort Study. eje. Retrieved October 1, 2022, from https://eje.bioscientifica.com/view/journals/eje/184/1/EJE-20-0628.xml.