Dilemma in the Treatment of Paediatric Vagal Paraganglioma

Abstract

Vagal paraganglioma is a rare tumour of the head and neck region, particularly in           the paediatric age groups. A 13-year-old girl presented at the Department of Otorhinolaryngology, Head & Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre Malaysia with painless left neck swelling, associated with multiple cranial nerve palsies for 14 months. The neck swelling was diagnosed as a carotid body tumour initially, but it was deemed inoperable, and the child received radiotherapy instead. The treatment response was suboptimal. Upon re-evaluating the radiological images, a revised diagnosis of vagal paraganglioma was made. Her family refused surgical intervention, and the child was treated conservatively. Over the last four years, serial imaging has demonstrated a decrease in tumour size. Although vagal paraganglioma in paediatric may require surgical excision, there is still a role in the wait-and-see approach. Frequent follow-up with radiological surveillance can save patients from surgical morbidity.