Citation: Niema Benkhraba et al. Paragangliomas of Nasal Cavity: A Case Report. Sch J Med Case Rep, 2021 June 9(6): 673-675. 673
Scholars Journal of Medical Case Reports
Abbreviated Key Title: Sch J Med Case Rep
ISSN 2347-9507 (Print) | ISSN 2347-6559 (Online)
Journal homepage: https://saspublishers.com
Paragangliomas of Nasal Cavity: A Case Report
Niema Benkhraba
1
,
3*
, Mohamed Ali Gliti
1
,
3
, Ihssane Allouch
1
,
3
, Sophia Nitassi
2
,
3
, Bencheikh Razika
2
,
3
, Benbouzid
Mohamed Anas
2
,
3
, Abdelilah Oujilal
2
,
3
, Leila Essakalli Houssyni
2
,
3
1
Resident physician in otorhinolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Ibn Sina University
Hospital, Rabat, Morocco
2
Professor of otorhinolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Ibn Sina University Hospital, Rabat,
Morocco
3
Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
DOI: 10.36347/sjmcr.2021.v09i06.015 | Received: 19.04.2021 | Accepted: 27.05.2021 | Published: 22.06.2021
*Corresponding author: Niema Benkhraba
Abstract Case Report
Paraganglioma is a rare neuroendocrine tumor. Nasal localization is very rare. Head and neck paragangliomas
represent only 0.6% of head and neck tumors and 3% of all paragangliomas. The treatment is based on surgery.
Radiotherapy is indicated if the surgery does not provide complete resection. We report the case of a 36-year-old
patient who has had left nasal obstruction with epistaxis for 2 years. The CT scan shows a solid mass centered on the
left nasal cavity, puffy, without signs of aggression, benign-looking. The patient underwent a complete endoscopic
endonasal tumor removal after preoperative external carotid embolization. Pathological analysis with
immunohistochemistry confirmed the diagnosis of paraganglioma. The follow-up to the treatment was favorable.
Keywords: Paragangliomas, Nasal cavity, Surgery, Radiotherapy, Embolization.
Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
Paraganglioma is a rare neuroendocrine tumor
resulting from the migration of neural crest cells
associated with the autonomic nervous system [10, 14].
The sanctuary sites for these tumors are the medullary
portion of the adrenal gland (pheochromocytomas),
intercarotid glomus, and jugulotympanic glomus [14].
Nasopharyngeal paraganglioma is one of the rare
locations of paragangliomas of the head and neck which
themselves represent only 3% of all paragangliomas [3].
The aim of this work is to report a rare localization of
paragangliomas.
CASE REPORT
This is a 36-year-old patient, followed for
hypothyroidism, who has presented for 2 years with
progressive worsening left unilateral nasal obstruction,
associated with epistaxis, clear and sometimes purulent
anterior rhinorrhea. Without facial pain and without
associated ophthalmological signs. Clinical examination
found a deformation of the nasal pyramid, with the
presence of a fleshy tumor bleeding on contact
obstructing the entire left nasal cavity and exerting a
mass effect on the contralateral nasal cavity, the nasal
flow was abolished on the left side and very reduced on
the right side (Figure 1). CT scan of the nasal cavity and
cavum shows a lesional process centered on the left
nasal cavity, dense, moderately enhanced and
heterogeneous. This process blows the bony cortex of
the jawbone downwards, the bony skeleton of the
inferior turbinate, and the internal wall of the left
maxillary sinus laterally. Forward, it fills the nostril.
And back, it fills the choana and bombs in the
nasopharyngeal lumen. With retentional sphenoidal and
left maxillary sinusitis (Figure 2).
An anatomopathological study of a biopsy of
the tumor shows a morphological appearance
suggesting a paraganglioma of the nasal cavities or an
inverse papilloma. An immunohistochemical
complement was done, returning in favor of a
paraganglioma.
The patient received preoperative
embolization. A complete exeresis of the tumor of the
left nasal cavity was performed by endonasal
endoscopic approach (Figure 3). The definitive
anatomopathological study concluded in a
paraganglioma. The operative consequences were
simple. The evolution was favorable with no signs of
recurrence with a 1-year follow-up.