1
|
Sachani H, Tripathi M, Madhusudan KS, Semalti K, Shanker S, ArunRaj ST, Bal C. Thoracic Extradural Paraganglioma Localized on 68Ga-DOTANOC PET/CT. Clin Nucl Med 2021; 46:e471-e472. [PMID: 33826566 DOI: 10.1097/rlu.0000000000003643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We present the case of a 33-year-old woman with complaints of headache and palpitations with raised urinary catecholamines. Ultrasound of the abdomen was noncontributory, and the patient was referred for 68Ga-DOTANOC PET/CT, which revealed tracer accumulation in the thecal sac/spinal canal at D5-D7 level, suggestive of a thoracic paraganglioma. MRI of the spine subsequently confirmed the presence of an extradural mass in the spinal canal extending from D4 to D8.
Collapse
Affiliation(s)
| | | | | | - Kapil Semalti
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | |
Collapse
|
2
|
Vadi SK, Mittal BR, Parihar AS, Kumar R, Singh H, Singh G. 68Ga-DOTANOC PET/CT in an Atypical Extraskeletal Paravertebral Hemangioma Mimicking as Neurogenic Tumor in a Known Case of Breast Cancer. Clin Nucl Med 2019; 44:e364-e366. [PMID: 30829863 DOI: 10.1097/rlu.0000000000002521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ga-DOTANOC PET/CT is well documented in evaluation of well-differentiated neuroendocrine tumors and in other lesions with somatostatin receptor expression such as pheochromocytoma, paraganglioma, neuroblastoma, meningioma, and mesenchymal tumors causing oncogenic osteomalacia. Causes of interpretative pitfalls include prominent pancreatic uncinate process activity, inflammation, osteoblastic activity (degenerative bone disease/fracture/vertebral hemangioma), splenunculi/splenosis, and others. We present a case of extraskeletal paravertebral lesion detected in a known case of breast cancer with increased Ga-DOTANOC uptake later proved to be hemangioma. This is a novel finding and should be kept as a rare benign differential in evaluation of lesions with somatostatin receptor expression.
Collapse
Affiliation(s)
| | | | | | - Rajender Kumar
- From the Departments of Nuclear Medicine and PET/CT, and
| | | | - Gurpreet Singh
- Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
3
|
Thomson N, Pacak K, Schmidt M, Palmer C, Salzman K, Champine M, Schiffman J, Cohen A. Leptomeningeal dissemination of a low-grade lumbar paraganglioma: case report. J Neurosurg Spine 2017; 26:501-506. [PMID: 28128698 DOI: 10.3171/2016.10.spine16948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Leptomeningeal dissemination of paraganglioma is rare, with only 2 prior cases in the literature. The authors present the case of a metastatic low-grade lumbar paraganglioma via leptomeningeal dissemination. This report emphasizes the utility of 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (18F-FDOPA) PET scanning for diagnosis, as well as the combination of radiation therapy and alkylating chemotherapeutic agents for the treatment of this rare phenomenon. The patient was a 61-year-old woman who presented with low-back pain and was found to have an isolated L-3 intrathecal tumor on MRI. Sixteen months after gross-total en bloc resection of the paraganglioma, the patient again became symptomatic with new neurological symptoms. MRI findings revealed enhancing leptomeningeal nodules throughout the spine. 18F-FDOPA PET/CT scanning was used to confirm the diagnosis of disseminated paraganglioma. Intrathecal thiotepa, radiation therapy, and systemic therapy with capecitabine and temozolomide have been used sequentially over a 2-year period, with each able to stabilize tumor growth for several months. The authors also summarize the 2 other reports of leptomeningeal dissemination of paragangliomas in the literature and compare the course and management of the 3 cases.
Collapse
Affiliation(s)
- Nick Thomson
- Department of Internal Medicine, University of Arizona College of Medicine Phoenix, Arizona
| | - Karel Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Meic Schmidt
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Cheryl Palmer
- Department of Pathology, Division of Anatomic Pathology, University of Utah, Salt Lake City, Utah,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Karen Salzman
- Department of Radiology, Division of Neuroradiology, University of Utah, Salt Lake City, Utah,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Marjan Champine
- Huntsman Cancer Institute, Salt Lake City, Utah,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Joshua Schiffman
- Department of Pediatrics and Oncological Sciences, University of Utah, Salt Lake City, Utah,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Adam Cohen
- Department of Medicine, Division of Oncology, University of Utah, Salt Lake City, Utah,Huntsman Cancer Institute, Salt Lake City, Utah
| |
Collapse
|