title: Multiple recurring paragangliomas: a problem of diagnosis and location. Case report and review of the literature.
abstract: BACKGROUND
  Paragangliomas constitute a particular diagnostic challenge because of the difficulties involved in identifying new lesions.
  
  
  METHODS
  The findings in the case of a young woman with multiple recurring paragangliomas which reappeared eleven years after successful surgical treatment are presented.
  
  
  CONCLUSIONS
  This case illustrates the diagnostic difficulties of this pathologic entity and the lack of a technique of sufficient sensitivity to reveal the existence of one or more tumors with or without hormonal secretion, their location and rate of growth and the number of neoplasias to avoid as many surgical interventions as possible. Inasmuch as an ideal technique for diagnosis and localization of this type of tumor remains to be developed, non-invasive methods, particularly 131I MIBG scintigraphy, play a significant role in evaluation because of their high sensitivity for detecting chromaffin tissue, especially in extra-adrenal locations.
  
  
  CONCLUSIONS
  Periodic long-term radionuclide scanning should be recommended for all asymptomatic patients given the risk of residual and/or reactivating tumoral tissue with benign or metastatic behavior.
authors.affiliation: Instituto Nacional de la Nutrición Salvador Zubirán, México City.
authors.forename: V
authors.initials: V
authors.lastname: Rebollar
authors.forename: A
authors.initials: A
authors.lastname: Orea
authors.forename: J
authors.initials: J
authors.lastname: Sepúlveda
authors.forename: J
authors.initials: J
authors.lastname: Dorantes
authors.forename: C
authors.initials: C
authors.lastname: Keirns
authors.forename: J
authors.initials: J
authors.lastname: Oseguera
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D010235:Paraganglioma / Q000175:diagnosis* / Q000601:surgery*