title: Case report: patient with multiple paragangliomas treated with long acting somatostatin analogue.
abstract: Paragangliomas of the head and neck are uncommon neoplasms. They are usually benign, but tend to be locally invasive. Although surgical resection remains the definitive treatment, important issues about management arise when such lesions are inoperable. Beneficial effects of octreotide treatment have already been reported in a malign paraganglioma case. Here we report a 24 year old female with familial, bilateral, multiple paraganglioma in the head and neck region, who firstly presented with pulsatile tinnitus and hearing loss in her left ear. After embolization was performed, she underwent operation twice because of the gross tumor mass. No significant change in tumor size was determined after the operations, however there were no distant metastases. Although she experienced hypertension attacks, no hormonal overproduction was found in repeated measurements. As the tumor was unresectable, new alternative therapies were sought. Octreotide scintigraphy was positive in the tumoral tissue, so we began to treat her with somatostatin analogue octreotide. After a 16 month follow up period, an improvement of the performance status, the near normalisation of attacks and stabilization of tumor growth were achieved. However, in the last three visits, she began to experience symptoms more frequently and it had been necessary to increase the octreotide dose. She is now well and being followed up. In conclusion, the beneficial effects of octreotide treatment could be quantified by clinical, tumor and scintigraphic criteria. These data suggest that octreotide can be useful in the treatment of inoperable paragangliomas.
authors: Department of Endocrinology and Metabolic Diseases, Ankara University, School of Medicine, Turkey.
authors: Vedia
authors: V
authors: Tonyukuk
authors: Rifat
authors: R
authors: Emral
authors: Sule
authors: S
authors: Temizkan
authors: Ayşe
authors: A
authors: Sertçelik
authors: Ilhan
authors: I
authors: Erden
authors: Demet
authors: D
authors: Corapçioğlu
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009377:Multiple Endocrine Neoplasia / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010235:Paraganglioma / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011877:Radionuclide Imaging
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D015282:Octreotide