Extracranial head and neck neurogenic tumors: report of 47 cases

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Olfa Ben Gamra
Nadia Romdhane
Khaled Khamassi
Inès Nacef
Wafa Abid
Chiraz Chammakhi
Ines Hariga
Chiraz Mbarek

Abstract

Summary
Extracranial head and neck neurogenic tumors are rare and usually revealed by histological examination. The aim of this study was to review the clinical, radiological and therapeutic particularities of these tumors.
Methods: This retrospective study concerns 47 patients with neurogenic tumors of the head and neck, operated on between 1989 and 2011 (22 years period). All patients had complete physical examination and ultrasonography was performed when a cervical extension was found. CT scan and MRI were performed in 16 cases. Minimum follow up was 4 years.
Results:  A sinusonasal tumor was found in 9 cases and a cervical mass was seen in 28 cases. Parapharyngeal extension was observed in two cases. Two patients had tympano-jugular glomic tumors and 8 of them had a cervical soft tissue tumor.
Complete surgical resection was performed in 46 patients.
Histological examination revealed a benign tumor in 91% of cases (n=43), 24 of them were schwannomas. Malignant tumors were seen in 4 cases: esthesioneuroblastoma (3 cases) and malignant schwannoma (1 case). These patients received post operative radiotherapy.
After surgery, two patients had Claude Bernard Horner syndrome and one had a definitive facial nerve palsy.
Conclusion: Extracranial head and neck neurogenic tumors may have several aspects depending on their localisation and their histological type. Surgery, when performed, should be complete with minimum complications.

Keywords:

Neck swelling, neurogenic tumors, Schwannoma, Surgery

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References

  1. Bouilloud, F., Jegoux, F., Caze, A., Godey, B. Le Clech, G. Tumeurs parapharyngées: diagnostic et traitement. Annales d'Otolaryngologie et de Chirurgie Cervico-faciale 2008;125(4) :181-7.
  2. Le Guellec. Les tumeurs des gaines des nerfs périphériques. Annales de Pathologie 2015 ;35(1) :54-70.
  3. Weber, A. L., Montandon, C., & Robson, C. D. Neurogenic tumors of the neck. Radiologic Clinics of North America 2000;38(5):1077-90.
  4. Zhi, K., Ren, W., Zhou, H., Wen, Y. Zhang, Y. Management of parapharyngeal-space tumors. Journal of Oral and Maxillofacial Surgery 2009;67(6),1239-44.
  5. Riffat, F., Dwivedi, R. C., Palme, C., Fish, B. Jani, P. A systematic review of 1143 parapharyngeal space tumors reported over 20 years. Oral oncology 2014;50(5):421-30.
  6. John DG, Carlin WV, Brown MJ. Tumours of the parapharyngeal space. J R CollSurgEdinb 1988;33(2):56-60.
  7. Mediouni, A., Ammari, S., Wassef, M., Gimenez-Roqueplo, A. P., Laredo, J. et al. Histoire naturelle des paragangliomes malins de la tête et du cou. Analyse comparative. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2014 ;131(3) :145-51.
  8. Lack E. Tumors of the adrenal glands and extraadrenalparaganglia. In: Press SSA, editor. AFIP Atlas of tumor pathology 2007;30:14-20.
  9. Aydi, Z., Daoud, F., Hassen, I. B., Menif, I., Baili, L., Dhaou et al. Imagerie des paragangliomeslatéro-cervicaux et abdominaux. Annales d'Endocrinologie 2014 ;75(5) :364.
  10. Makeieff, M., Thariat, J., Reyt, E., &Righini, C. A. Traitement des paragangliomes cervicaux. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2012 ;129(6),361-7.
  11. Kim S, Kim N, Kim KR, Lee JH, Choi HS. Schwannoma in Head and Neck: Preoperative ImagingStudy and IntracapsularEnucleationfor Functional Nerve Preservation. Yonsei Med J 2010 ;51(6):938-42
  12. Stucky CC, Johnson KN, Gray RJ, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic Experience. Ann SurgOncol 2012; 19:878-85
  13. Vidaud D, Lévy P, Laurendeau I, et al. Approche moléculaire des MPNSTs dans la neurofibromatose de type 1 : vers l'identification de marqueurs diagnostiques et pronostiques. Arch Pediatr2008 ;15:809-11
  14. Scheithauer BW, Louis DN, Hunter S, et al. Malignant peripheral nerve sheath tumour (MPNST). WHO Classification of tumours of the central nervous system 2007:160-2
  15. Farid, M., Demicco, E. G., Garcia, R., Ahn, L., Merola, P. R., Cioffi, A., & Maki, R. G. Malignant peripheral nerve sheath tumors. The oncologist 2014;19(2): 193-201.
  16. Touil, H.,Briki, S., Karray, F., &Bahri, I. Schwannome malin du plexus cervical superficiel à extension intraparotidienne. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2015 ;132(2) :90-2.
  17. Ali NS, Junaid M, Aftab K. Malignant peripheral nerve sheath tumour of maxilla. J CollPhysicianSurgPak 2011;21:420-2.
  18. Tekaya R, Hamdi W, Azzouz D, et al. Névralgie cervicobrachiale révélatrice d'un neurofibrosarcome (MPNST) cervical. RevNeurol 2008;164:82-6
  19. M. V. Dimitrijevic, S. D. Jesic, A. A. Mikic, N. A. Arsovic, N. R. Tomanovic. Parapharyngeal space tumors: 61 case reviews. Int. J. Oral Maxillofac. Surg. 2010;39: 983-9.
  20. Su SY, Bell D, Hanna EY. Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma: differentiation in diagnosis and treatment.Int Arch Otorhinolaryngol. 2014;18:149-56.
  21. Monteiro EM, Lopes MG, Santos ER, Diniz CV, Albuquerque AS, Monteiro AP et al. Endoscopic treatment of esthesioneuroblastoma. Braz J Otorhinolaryngol. 2011;77(2):171-7.
  22. Muñoz F, Tresserras P, Montserrat JR, Sancho FJ, Bartumeus F.A retrospective study about 11 cases of Esthesioneuroblastomas treated in Hospital Santa Creu Sant Pau between 2000 and 2008 and literature review. Neurocirugia (Astur). 2011;22(5):401-17.
  23. Albsoul N, Rawashdeh B, Albsoul A, Abdullah M, Golestani S, Rawshdeh A et al.A rare case of extracranial meningioma in parapharyngeal space presented as a neck mass.Int J Surg Case Rep. 2015;11:40-3.
  24. Maeng JW, Kim YH, Seo J, Kim SW. Primary extracranial meningioma presenting as a cheek mass. Clin Exp Otorhinolaryngol 2013;6(4):266-8.