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Tympanic paraganglioma mimicking cholesteatoma: about a case.

Abstract Tympanic paragangliomas are common benign tumors of the middle ear, made up of neuroendocrine cells dispersed along the major vascular axes of the head, the neck and the vertebral column. The revealing symptoms are hearing loss and a pulsatile tinnitus. Otoscopy often shows pulsatile retrotympanic reddish mass. MRI and somatostatin analogue scintigraphy (OctreoScan) are the imaging modality of choice. OctreoScan allows physicians to detect other tumor locations. The dosage of urinary methoxyl derivatives is determined, complemented by the screening of other components of multiple endocrine neoplasias (MEN). Biopsy is contraindicated because of the risk of hemorrhage. Surgery is the treatment of choice. We report the case of F. A., a 75-year old patient, admitted with tympanic paraganglioma revealed by hearing loss in his right ear (occurred 4 years before) associated with pulsatile tinnitus concomitant with the heart beating in his ear. He underwnt otoscopy showing retrotympanic reddish pulsatile mass in his right ear (A). (B) MRI of the brain showed total involvement of the middle ear and of the mastoid cells, without identifiable tumoral process, with distinct hyperintensity on diffusion-weighted imaging and strong contrast-enhancement. MEN assessment was without abnormalities, including 24h methoxyl derivatives, parathyroid hormone and calcitonin. The diagnosis of paraganglioma was retained because of the strong contrast-enhancement. OctreoScan was indicated before surgery.
PMID
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Authors

Mayor MeshTerms
Keywords

Paragangliolma

cholesteatoma

pulsatile tinnitus

Journal Title the pan african medical journal
Publication Year Start




PMID- 29541315
OWN - NLM
STAT- MEDLINE
DCOM- 20180322
LR  - 20180322
IS  - 1937-8688 (Electronic)
VI  - 28
DP  - 2017
TI  - [Tympanic paraganglioma mimicking cholesteatoma: about a case].
PG  - 169
LID - 10.11604/pamj.2017.28.169.13033 [doi]
AB  - Tympanic paragangliomas are common benign tumors of the middle ear, made up of
      neuroendocrine cells dispersed along the major vascular axes of the head, the
      neck and the vertebral column. The revealing symptoms are hearing loss and a
      pulsatile tinnitus. Otoscopy often shows pulsatile retrotympanic reddish mass.
      MRI and somatostatin analogue scintigraphy (OctreoScan) are the imaging modality 
      of choice. OctreoScan allows physicians to detect other tumor locations. The
      dosage of urinary methoxyl derivatives is determined, complemented by the
      screening of other components of multiple endocrine neoplasias (MEN). Biopsy is
      contraindicated because of the risk of hemorrhage. Surgery is the treatment of
      choice. We report the case of F. A., a 75-year old patient, admitted with
      tympanic paraganglioma revealed by hearing loss in his right ear (occurred 4
      years before) associated with pulsatile tinnitus concomitant with the heart
      beating in his ear. He underwnt otoscopy showing retrotympanic reddish pulsatile 
      mass in his right ear (A). (B) MRI of the brain showed total involvement of the
      middle ear and of the mastoid cells, without identifiable tumoral process, with
      distinct hyperintensity on diffusion-weighted imaging and strong
      contrast-enhancement. MEN assessment was without abnormalities, including 24h
      methoxyl derivatives, parathyroid hormone and calcitonin. The diagnosis of
      paraganglioma was retained because of the strong contrast-enhancement. OctreoScan
      was indicated before surgery.
FAU - Rafiq, Bouchra
AU  - Rafiq B
AD  - Service d'Endocrinologie-Diabetologie, Maladies Metaboliques et Nutrition,
      Laboratoire PCIM, FMPM, Universite Cadi Ayyad, CHU Mohamed VI, CHU Mohamed VI,
      Marrakech, Maroc.
FAU - Mghari, Ghizlane El
AU  - Mghari GE
AD  - Service d'Endocrinologie-Diabetologie, Maladies Metaboliques et Nutrition,
      Laboratoire PCIM, FMPM, Universite Cadi Ayyad, CHU Mohamed VI, CHU Mohamed VI,
      Marrakech, Maroc.
LA  - fre
PT  - Case Reports
PT  - Journal Article
TT  - Paragangliome tympanique simulant un cholesteatome: a propos d'un cas.
DEP - 20171020
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
SB  - IM
MH  - Aged
MH  - Cholesteatoma/*diagnosis
MH  - Ear Neoplasms/complications/*diagnosis/surgery
MH  - Hearing Loss/*etiology
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Otoscopy
MH  - Paraganglioma/complications/*diagnosis/surgery
MH  - Tinnitus/etiology
PMC - PMC5847258
OTO - NOTNLM
OT  - Paragangliolma
OT  - cholesteatoma
OT  - pulsatile tinnitus
EDAT- 2018/03/16 06:00
MHDA- 2018/03/23 06:00
CRDT- 2018/03/16 06:00
PHST- 2017/06/11 00:00 [received]
PHST- 2017/09/17 00:00 [accepted]
PHST- 2018/03/16 06:00 [entrez]
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2018/03/23 06:00 [medline]
AID - 10.11604/pamj.2017.28.169.13033 [doi]
AID - PAMJ-28-169 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 Oct 20;28:169. doi: 10.11604/pamj.2017.28.169.13033.
      eCollection 2017.