Basaloid squamous cell carcinoma clinically and radiologically masquerading as a head and neck paraganglioma: a case report and review of the literature

TL;DR

A rare case of basaloid squamous cell carcinoma was mistaken for a paraganglioma in a 66-year-old man, highlighting diagnostic challenges in head and neck tumors.

Contribution

This is the first reported case of basaloid squamous cell carcinoma masquerading as a head and neck paraganglioma.

Findings

The tumor was initially diagnosed as a paraganglioma based on clinical and radiological findings.

Histopathological and immunohistochemical analysis confirmed it as a basaloid squamous cell carcinoma.

The patient underwent successful resection and radiotherapy with no postoperative complications.

Abstract

This paper reports the first case of basaloid squamous cell carcinoma clinically and radiologically masquerading as a head and neck paraganglioma.

A 66-year-old Sinhalese male with unilateral hearing impairment and 7th–12th (excluding 11th) cranial nerve palsies was diagnosed radiologically with a head and neck paraganglioma by magnetic resonance imaging of the brain, which revealed a hypointense and hyperintense punctate mass centered at the jugular fossa with intracranial extension. The ascending pharyngeal artery, recognized as the major feeder, was embolized by percutaneous embolization following digital subtraction angiography. Gross total resection of the tumor was followed by an uneventful postoperative recovery. Combined immunohistochemistry and histopathological morphology revealed a basaloid squamous cell carcinoma, following which the patient completed radiotherapy and is at 3-month follow-up currently.

This case report discusses the diagnostic pitfalls and management challenges of this rare entity on the basis of prior evidence, as well as a literature review and clinical and surgical analysis.

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