Scintigraphic evaluation of glomus tumours.
The current investigations of choice for a suspected glomus tumour are either direct or indirect angiography to include digital subtraction followed by computerized tomography (CT) or magnetic resonance imaging (MRI) or, if available, CT and MRI with gadolinium alone. Although these modalities confirm the diagnosis and give anatomical information to facilitate accurate staging, they do not provide functional data. The use of radionuclide scintigraphy can add an extra physiological dimension to glomus tumour imaging. Iodine-131/123 metaiodobenzylguanidine (MIBG) is a tumour imaging agent which has been used to diagnose head and neck neuroendocrine tumours to include paragangliomata and medullary carcinoma of the thyroid (MCT). However, it is expensive and the new head and neck tumour imaging agent technetium-99 m (Tc99m) (v) dimercaptosuccinic acid (DMSA) has superceded it as the imaging agent of choice to evaluate MCT. We report a patient with a glomus jugulare tumour which was evaluated with I131/I123-MIBG and Tc99m (v) DMSA. The tumour was functional and is the first reported case exhibiting positive accumulation of both I131-MIBG and Tc99m (v) DMSA. The patient was subsequently treated with a therapeutic dose of I131-MIBG. The significance of these results is discussed.
Rockall
T A
TA
Department of Otolaryngology, Guys Hospital, London.
Watkinson
J C
JC
Clark
S E
SE
Douek
E E
EE
D019797:3-Iodobenzylguanidine; D003287:Contrast Media; D005260:Female; D005925:Glomus Jugulare Tumor / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010236:Paraganglioma, Extra-Adrenal / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
D003287:Contrast Media; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D015609:Organotechnetium Compounds; D019797:3-Iodobenzylguanidine; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer