Feasibility of a wait-and-scan period as initial management strategy for head and neck paraganglioma.

Abstract

The main goal of head and neck paraganglioma (PGL) management is reduction of treatment-induced and tumor-induced complications. In the current study, tumor growth rates and tumor-induced complications during a wait-and-scan period are evaluated. This was a retrospective cohort study. Tumor growth was measured in axial plane diameter and tumor volume. Of 59 jugulotympanic tumors, 71 carotid body tumors, and 29 vagal body tumors, 44% were growing (median follow-up of 63.6 months). Median growth rates were 0.41 mm/year (range 0-439 mm), 1.6 mm/year (range 0-23.68 mm), and 1.6 mm/year (range 0-23.68 mm) respectively. Growth was significantly correlated to age at presentation (odds ratio [OR] = 0.974; P < .05). Seventeen tumors induced 20 complications. Six of these tumors were growing, and growth rates were higher than in tumors not inducing complications (P = .016; F = 6.496). These results illustrate the feasibility of a wait-and-scan strategy for head and neck PGL. The management strategy could not prevent tumor-induced complications in 16% of nongrowing tumors.