Second primary tumors in patients with a head and neck paraganglioma
Kevin J. Contrera MD, MPH
Cleveland Clinic, Head & Neck Institute, Cleveland, Ohio
Search for more papers by this authorValeda Yong MD
School of Medicine, Case Western Reserve University, Cleveland, Ohio
Search for more papers by this authorChandana A. Reddy MS
Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio
Search for more papers by this authorEren Berber MD
Department of Endocrine Surgery, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, Ohio
Search for more papers by this authorCorresponding Author
Robert R. Lorenz MD, MBA
Cleveland Clinic, Head & Neck Institute, Cleveland, Ohio
Correspondence
Robert R. Lorenz, Cleveland Clinic, Head and Neck Institute, 9500 Euclid Ave, A71, Cleveland, OH 44195.
Email: [email protected]
Search for more papers by this authorKevin J. Contrera MD, MPH
Cleveland Clinic, Head & Neck Institute, Cleveland, Ohio
Search for more papers by this authorValeda Yong MD
School of Medicine, Case Western Reserve University, Cleveland, Ohio
Search for more papers by this authorChandana A. Reddy MS
Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio
Search for more papers by this authorEren Berber MD
Department of Endocrine Surgery, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, Ohio
Search for more papers by this authorCorresponding Author
Robert R. Lorenz MD, MBA
Cleveland Clinic, Head & Neck Institute, Cleveland, Ohio
Correspondence
Robert R. Lorenz, Cleveland Clinic, Head and Neck Institute, 9500 Euclid Ave, A71, Cleveland, OH 44195.
Email: [email protected]
Search for more papers by this authorAbstract
Background
There are conflicting recommendations and possibly overuse of imaging for surveillance of second primary tumors for patients with a history of head and neck paraganglioma.
Methods
Retrospective cohort study of 234 adults with head and neck paragangliomas (1990-2010) followed for a mean of 7.5 ± 8.4 years.
Results
The rate of second paraganglioma was 1.7% after 5 years and 5.1% after 10 years, yielding an incidence of 6.65 per 1000 person-years. Only 1.3% of patients (2.59 per 1000 person-years) ever had a second paraganglioma in the chest, abdomen, or pelvis. Patients with a hereditary paraganglioma (hazard ratio [HR] = 4.84, 95% confidence interval [CI]: 1.52-15.43) or carotid body tumor (HR = 3.55, 95% CI: 1.15-10.99) were at greater risk.
Conclusions
The incidence rate of a second primary paragangliomas is low but increases with hereditary disease. These results question the utility of repeated imaging outside of the neck to screen for second paragangliomas.
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