Analysis of clinical characteristics of paraganglioma in 42 patients

Abstract

Objective: To summarize the clinical characteristics of paraganglioma. Methods: A total of 215 pheochromocytoma/ paraganglioma cases in Peking University First Hospital between January 1996 and December 2014 were retrospectively analyzed. The patients were divided into two groups according to the tumor position: pheochromacytoma group (173 patients) and paraganglioma group (42 patients). Then the clinical characteristics between the groups were compared. Results: There were 42 paraganglioma cases in the study, accounting for 19.5%. The most common position was retroperitoneum (66.7%, 28/42), followed by bladder (19.0%, 8/42), para-aorta (11.9%, 5/42) and pelvic cavity (2.4%, 1/42). Sixty-nine percent (29/42) of patients had different degree of hypertension, while up to 31.0% (13/42) was silent type. There was no statistical difference between the two groups in severity of hypertension, age, gender, duration, abnormal glucose metabolism, and the incidence of hypokalemia( all P>0.05). Adrenaline level was higher in pheochromocytoma group (13.4% vs 9.5%, P=0.004), while noradrenaline level was higher in paraganglioma group (80.8% vs 59.2%, P=0.001). Malignancy (21.4% vs 4.6%, P<0.001) and bigger tumor size [(6.67±3.24)cm vs (5.55±2.76)cm, P=0.024] was more common in paraganglioma group. The maximum tumor volume was 18.0 cm×18.0 cm×10.5 cm vs 14.0 cm×13.0 cm×7.0 cm, while the minimum was 1.8 cm×1.3 cm×1.3 cm vs 1.2 cm×1.0 cm×1.0 cm. There was no significant difference in the pathological manifestations between the two groups. In the study, 11.9% (5/42) of patients in paraganglioma group was misdiagnosed or indefinite at the early diagnosis. Conclusion: Compared with pheochromocytoma, paraganglioma has the characteristics of widely distribution, more various clinical performance, more silent type and higher malignant rate. It is critical to put emphasis on its early diagnosis and treatment.