[Relevance of nuclear medicine in the diagnosis and treatment of malignant paraganglioma].
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.


METHODS
A 34-year-old male was diagnosed with a paraganglioma at the level of the aortic bifurcation by means of laboratory tests, imaging studies and nuclear medicine studies. Nuclear medicine was carried out with a scintigraphy with a norepinephrine analog, radioactive meta-iodo-benzyl-guanidine (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 to 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.
Aguilar-Olivos
Nancy Edith
NE
Departamento de Medicina Nuclear e Imagen Molecular PET-CT, Centro Médico ABC, IAP, México, D.F., Mexico. naedith@hotmail.com
García-Ortiz
José Rafael
JR
Rojas-Reyna
Guillermo Alfonso
GA
Chaparro-González
Juan Manuel
JM
Weisser-Jacobs
Fred
F
Oria-Hernández
Jesús
J
D000328:Adult; D001012:Aorta, Abdominal; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D010235:Paraganglioma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D011877:Radionuclide Imaging; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*