Malignant and benign sinonasal paragangliomas.

Objectives/hypothesis: To report on the clinical course and management of sinonasal paragangliomas (PGLs).

Study Design And Methods: Retrospective chart review of six patients with PGLs of the nasal cavity and paranasal sinuses.

Results: Three patients had tumors with malignant clinical behavior with cerebral metastases or infiltration of brain and local recurrence, despite surgery and/or radiotherapy, while three patients demonstrated a benign course.

Conclusion: Sinonasal paragangliomas are frequently malignant. If malignant, they are very aggressive, with rapid local spread as well as high metastatic potential despite surgical resection; and they have a poor prognosis. Malignancy cannot be diagnosed on histology, but only on the basis of clinical behavior. Intracranial metastasis is commonly expected. Long-term follow-up, with particular emphasis put on the intracranial structures, is mandatory as recurrences or metastasis may occur even after a long time interval.