title: Radiological and pathological findings of a metastatic composite paraganglioma with neuroblastoma in a man: a case report.
abstract: BACKGROUND
  Composite tumors of the adrenal medulla or paraganglia are extremely rare and present a diagnostic dilemma. These tumors consist of a neuroendocrine component mixed with a neural component.We describe the imaging characteristics together with the corresponding pathological findings of a composite tumor. Apart from any component-specific imaging findings, the hallmark of this entity is the presence of histologically distinguishable components.
  
  
  METHODS
  A 61-year-old Caucasian man was referred to our hospital due to a suspect lesion found on chest computed tomography carried out for unclear thoracic pain. An abdominal computed tomography scan and ultrasound examination detected a retroperitoneal tumor comprising two different tumor components. Twenty-four-hour urine revealed high levels of normetanephrine, characteristic of a neuroendocrine tumor. An octreoscan prior to surgical procedures revealed multiple osseous and intra-hepatic metastases. The final histopathological workup revealed a composite paraganglioma with neuroblastoma. Our patient died ten months after the initial diagnosis from tumor-associated complications.
  
  
  CONCLUSIONS
  Composite paragangliomas with neuroblastoma are rare tumors of the retroperitoneum. Such tumors should be considered in the differential diagnosis of retroperitoneal masses.
authors.affiliation: Institute of Surgical Pathology, University Hospital Zurich, 8091 Zurich, Switzerland. florian.fritzsche@usz.ch.
authors.forename: Florian R
authors.initials: FR
authors.lastname: Fritzsche
authors.forename: Peter K
authors.initials: PK
authors.lastname: Bode
authors.forename: Sonja
authors.initials: S
authors.lastname: Koch
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder