title: Sinonasal paraganglioma with long-delayed recurrence and metastases: genetic and imaging findings.
abstract: BACKGROUND
  Sinonasal paragangliomas have rarely been reported in the literature. They are often aggressive.
  
  
  METHODS
  We report an original case of sinonasal paragangliomas with a tumor recurrence diagnosed 13 years after resection of the primary tumor. Somatostatin receptor scintigraphy and [18F]-fluorodeoxyglucose positron emission tomography/computed tomography were the most sensitive functional imaging techniques, and they ruled out distant metastases. Interestingly, [18F]-fluorodihydroxyphenylalanine positron emission tomography/computed tomography was negative, a feature that may be considered a sign of functional dedifferentiation. Screening for germline mutations of the SDHB, SDHC, SDHD, SDHAF2, VHL, MAX, and TMEM127 was negative.
  
  
  CONCLUSIONS
  The diagnosis of malignancy remains challenging at initial diagnosis, and patients should be followed during their entire lifetime.
authors.affiliation: MD, Department of Otorhinolaryngology, Head and Neck Surgery, LA Timone University Hospital, REFCOR, Aix-Marseille University, 264 rue Saint-Pierre, 13385 Marseille Cedex 5, France. Justin.michel@ap-hm.fr.
authors.forename: Justin
authors.initials: J
authors.lastname: Michel
authors.forename: David
authors.initials: D
authors.lastname: Taïeb
authors.forename: Marianne
authors.initials: M
authors.lastname: Jolibert
authors.forename: Julia
authors.initials: J
authors.lastname: Torrents
authors.forename: Michel
authors.initials: M
authors.lastname: Wassef
authors.forename: Isabelle
authors.initials: I
authors.lastname: Morange
authors.forename: Wassim
authors.initials: W
authors.lastname: Essamet
authors.forename: Anne
authors.initials: A
authors.lastname: Barlier
authors.forename: Patrick
authors.initials: P
authors.lastname: Dessi
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fakhry
mesh_terms: D004724:Endoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D010235:Paraganglioma / Q000235:genetics* / Q000556:secondary* / Q000601:surgery; D010256:Paranasal Sinuses; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed