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<p>Middle ear paragangliomas (ME-PGLs) are rare non-epithelial neuroendocrine neoplasms and the most common neoplasms of the middle ear. Tympanic paragangliomas (Ty-PGLs), a subset of ME-PGLs, are often biochemically non-functional, although prior studies have reported expression of cholinergic and, less frequently, catecholaminergic markers. The expression of functional biomarkers and somatostatin receptor type 2&#xa0;A (SSTR2A) remains poorly defined in Ty-PGLs. We analyzed three surgically resected Ty-PGLs from adult patients without hyperadrenergic symptoms using immunohistochemistry. All tumors exhibited strong, diffuse tyrosine hydroxylase expression; dopamine β-hydroxylase was negative in all cases, while choline acetyltransferase was focally positive in only one case. All Ty-PGLs showed moderate membranous SSTR2A expression. These findings indicate that a catecholaminergic immunophenotype may be relatively common in Ty-PGLs, challenging the traditional distinction between sympathetic and parasympathetic paragangliomas. Further studies are needed to clarify the clinical significance of these features and the physiological role of tympanic paraganglia.</p>

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Predominant catecholaminergic differentiation in tympanic paragangliomas: report of three consecutive cases

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Alessandro Vanoli,
  • Elena Carlotto,
  • Marco Minetto,
  • Federica Grillo,
  • Giuseppe Neri,
  • Marco Vincenzo Lenti,
  • Antonio Di Sabatino,
  • Alessandra Viglio,
  • Marco Paulli,
  • Stefano La Rosa,
  • Alessandra Pasini,
  • Deborah Marchiori,
  • Marco Benazzo,
  • Pietro Canzi

摘要

Middle ear paragangliomas (ME-PGLs) are rare non-epithelial neuroendocrine neoplasms and the most common neoplasms of the middle ear. Tympanic paragangliomas (Ty-PGLs), a subset of ME-PGLs, are often biochemically non-functional, although prior studies have reported expression of cholinergic and, less frequently, catecholaminergic markers. The expression of functional biomarkers and somatostatin receptor type 2 A (SSTR2A) remains poorly defined in Ty-PGLs. We analyzed three surgically resected Ty-PGLs from adult patients without hyperadrenergic symptoms using immunohistochemistry. All tumors exhibited strong, diffuse tyrosine hydroxylase expression; dopamine β-hydroxylase was negative in all cases, while choline acetyltransferase was focally positive in only one case. All Ty-PGLs showed moderate membranous SSTR2A expression. These findings indicate that a catecholaminergic immunophenotype may be relatively common in Ty-PGLs, challenging the traditional distinction between sympathetic and parasympathetic paragangliomas. Further studies are needed to clarify the clinical significance of these features and the physiological role of tympanic paraganglia.