Supraglottic paraganglioma originated from superior laryngeal nerve
A 64-year-old woman presented to our clinic with intermittent dysphagia to solid foods and dyspnea on effort from 2 months. She had history of goiter and gastroesophageal reflux; and was treated with Levothyroxin and Omeprazole.\nIndirect laryngoscopy revealed a left mass lesion at the level of supraglottis. Direct laryngoscopy and biopsy of mass was done. Biopsy revealed polypoid tissue lined by stratified squamous epithelium; acanthosis was seen; Exocytosis of lymphocytes and neutrophils in surface epithelium was present. The underlying stroma was edematous and had congested vessels. No evidence of malignancy was seen.\nIn neck sonography, a solid hypoechoic hypervascular mass (34 × 27 mm) was seen in the left paramedian, between left common carotid artery and larynx. There were two hypoechoic thyroid nodules (7 mm diameter in inferior pole and 4 mm in superior pole).\nSpiral neck CT scan with contrast revealed a large hypervascular mass which extended from epiglottis to the left vocal cord. It filled the left pyriform sinus, and narrowed airway tract with erosion to superior part of thyroid cartilage [].\nBiopsy from intraluminal space of hypopharynx was not diagnostic, so excision biopsy of mass was done.\nWith classic neck incision and exploration of carotid artery and vagus nerve, we found the tumor originated from superior laryngeal nerve, extending to supraglottic area. With preservation of superior laryngeal nerve, the tumor was dissected from supraglottic mucosa and excised completely. Because of edema of airway, prophylactic tracheostomy was done. Three days after the surgery, tracheostomy removed. Microscopic examination revealed the tumor as carotid body tumor (paraganglioma).\nAfter surgery, the patient suffered from dysphonia as a result of superior laryngeal nerve paresis that improved 3 months later.