2009, Number 3
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Cir Cir 2009; 77 (3)
Relevance of nuclear medicine in the diagnosis and treatment of malignant paraganglioma
Aguilar-Olivos NE, García-Ortiz JR, Rojas-Reyna GA, Chaparro-González JM, Weisser-Jacobs F, Oria-Hernández J
Language: Spanish
References: 23
Page: 233-239
PDF size: 275.48 Kb.
ABSTRACT
Background: Paragangliomas are neoplasms of the chromaffin
tissue characterized by the synthesis and/or secretion of
catecholamines. Their treatment depends on the extension and
functional characteristics of the tumor. In this pathology, the
anatomic and functional diagnostic evaluations provided by
nuclear medicine imaging studies have significant usefulness.
Clinical case: A 34-year-old male was diagnosed with a
paraganglioma at the aortic bifurcation level by means of
laboratory tests, imaging studies and nuclear medicine studies.
Nuclear medicine was carried out with a scintigraphy with a
norepinephrine analog, radioactive metaiodobenzylguanidine
(131I-MIBG), which demonstrates functionally and specifically
the presence of neoplastic adrenergic tissue and extratumoral
extension. In addition, a positron emission tomography coupled
with computed tomography with a radioactive analog of glucose
locates the extratumoral activity at bone level. Nuclear
medicine studies allow the diagnosis of a malignant
paraganglioma with presence of bone metastasis. The therapy
includes surgical removal of the tumor and ablation of residual
malignant tissue and metastatic lesions by radiotherapy with
131I-MIBG. Radiotherapeutic treatment was possible due to the
capacity of the tumor to uptake and concentrate the radioactive
hormonal analog.
Conclusions: In cases of paraganglioma, in addition to the
localization of the tumor and the evaluation of biochemical
alterations, it is indispensable to obtain anatomic and functional
evaluation provided by nuclear medicine studies in order to
achieve appropriate diagnoses and treatment.
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