title: Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal.
abstract: BACKGROUND
  Extraadrenal paragangliomas of the head and neck are tumors with variable clinical behavior. Because tumor growth as well as surgery can cause disabling loss of function, knowledge of the natural history of paragangliomas is important for the development of treatment strategies.
  
  
  METHODS
  The tumor volume, growth rate, and tumor doubling time of 48 paragangliomas at different anatomic locations in the head and neck region were estimated retrospectively using sequential radiologic imaging.
  
  
  RESULTS
  During a mean follow-up period of 4.2 years, a volume increase of > 20% was observed in 60% of the paragangliomas. In these cases the median growth rate was 1.0 mm/year and the median tumor doubling time was 4. 2 years. More growing tumors were observed in intermediate size tumors than in very small or large paragangliomas, suggesting a biphasic growth pattern.
  
  
  CONCLUSIONS
  The majority of head and neck paragangliomas have a very low growth rate. Although management of paragangliomas also is determined by other parameters, preoperative estimation of the tumor doubling time may influence the treatment proposal. A "wait and scan" policy must be considered in all cases.
authors.affiliation: Department of ENT, Head and Neck Surgery, Leiden University Medical Center, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Jansen
authors.forename: R
authors.initials: R
authors.lastname: van den Berg
authors.forename: A
authors.initials: A
authors.lastname: Kuiper
authors.forename: A G
authors.initials: AG
authors.lastname: van der Mey
authors.forename: A H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: C J
authors.initials: CJ
authors.lastname: Cornelisse
mesh_terms: D000328:Adult; D000368:Aged; D002455:Cell Division; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D010347:Patient Care Planning; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors