A paraphimosis is a change originating in the cells of the neuroendocrine system. In most cases, paragangliomas are benign tumors, but some of them may be malignant. What are the causes and symptoms of paraganglioma? How is such an endocrine tumor treated?
Paragangliomas(Latin paraganglioma) are neuroendocrine tumors that arise from cells of the neuroendocrine system that have undergone neoplastic transformation. Neuroendocrine cells are structures that are scattered throughout the human body. They secrete a number of different substances that are responsible for regulating, inter alia, the course of food digestion or controlling the activities of various organs of the endocrine system (e.g. thyroid gland). Due to their origin and the symptoms that appear through their presence, paragangliomas resemble a pheochromocytoma a bit. This type of neuroendocrine tumors is usually found in older patients - the peak incidence is observed in the 5th and 6th decade of life.
Paragangliomas are most often benign lesions, but there are also malignant forms among them.
Symptoms of paragangliomas vary - one of the potential complaints of patients is significant blood pressure disorders. The diagnosis of paraganglioma is important because, thanks to the treatment - based mainly on surgical procedures - in most patients it is possible to relieve them of their troubling ailments.
Pranchomycetes: causes
The causes of paragangliomas most often remain unclear. Most (even 3/4) of these lesions appear as sporadic tumors, the remaining part are forms of paragangliomas appearing as a result of inherited genetic disorders. An increased incidence of paragangliomas is observed in patients with:
- MEN2A and MEN2B multiple endocrine neoplasia syndromes,
- von Hippel-Lindau syndrome,
- type I neurofibromatosis,
- Carney's syndrome (micronodular adrenal hyperplasia).
Paragangliomas: types and symptoms
The classification of paragangliomas is not entirely clear. Some specialists believe that only those structures that originate from the paraganginal bodies of the parasympathetic system can be classified as such. Other authors belong to the group of paragangliomasthey also include those changes that originate from the paragaginal bodies of the sympathetic nervous system. Currently, the first view seems to be more popular, according to which paragangliomas are changes based on cells of the parasympathetic system. Paragangliomas can develop in various parts of the body - they are found both in the head and neck, as well as in the abdominal cavity. The most common changes in patients are:
- carotid paraganglioma (appearing around the bifurcation of the carotid artery)
- cervico-tympanic paraganglioma
- vagus nerve paraganglioma
The symptoms of paragangliomas are primarily dependent on the release of hormones by these tumors. The substances they produce may be mainly adrenaline and norepinephrine. As a result of the increased release of these hormones, patients may experience:
- a significant increase in blood pressure
- headaches
- extremely sweating
- suddenly appearing pale skin
- increased heart rate or palpitations
Apart from the above symptoms of paragangliomas, patients may also suffer from ailments closely related to the localization of pathogenic lesions. These include, for example, the presence of a palpable formation in the neck (in the case of the cervical paraganglioma), tinnitus and hearing loss of various degrees (seen in the course of the cervico-tympanic paraganglioma). In turn, dysphagia and hoarseness are observed in patients with vagal paraganglioma. However, it also happens that the paraganglioma does not produce any hormones - in such conditions the tumor may have no symptoms or only lead to the appearance of an unusual bulge in some area of the body. certain situations provoke the appearance of ailments in patients. These events include:
- experiencing high stress
- significant physical activity
- trauma experience
- childbirth
Paraggias: diagnostics
The diagnosis of paragangliomas is often quite difficult - these changes are rare diseases (paragangliomas of the head and neck region, according to statistics, constitute only about 0.03% of all human neoplasms), therefore diagnostic algorithms usually focus on completely different diseases . A doctor may suspect a neuroendocrine cell tumor by the presence of, for example, extremely resistant to treatment, especially episodic hypertension.ultrasound and computed tomography. In the case of various neoplastic lesions, biopsy tests are used, while if a paraganglioma is suspected in a patient, such treatment is definitely contraindicated - these tumors are usually highly vascularized, so taking a biopsy could be associated with a significant risk to the patient.
Paragangiomas: treatment and prognosis
Surgical procedures are used in the treatment of paragangliomas. If the tumor cannot be operated on, patients are given radiotherapy. The prognosis of patients with paraganglioma is good - complete tumor resection usually leads to a cure. The situation is worse for some patients with vagal paraganglioma, as this form of neuroendocrine tumor tends to malignant transformation and metastasize (secondary foci in this situation are mainly observed in the lungs).