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Year:
1998
| Volume: 6
| Issue: 1
| Pages: 31-32
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Case Report |
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MALIGNANT ZUCKERKANDL PARAGANGLIOMA
Milan PETAKOV, Svetozar DAMJANOVIC, Marina NIKOLIC, Miomira GLIGOROVIC, Sandra OBRADOVIC, Vera POPOVIC |
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DOI:
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Abstract: |
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A 27-year old female was admitted to the hospital because of hypertensive crisis (blood pressure 170/130 lying and 130/100 standing) with headache, palpitation, dizziness and shortness of breath. CT scan of the abdomen revealed a well defined heterogenously enhanced soft tissue mass measuring 4 x 3.5 cm in the left para-aortic region below the left renal vein. Urinary 24-hour noradrenaline and vanillylmandelic acid were elevated and confirmed the diagnosis of extra-adrenal pheochromocytoma. MIBG (131I-meta-iodobenzylgvanidine) scintiscan showed increased MIBG uptake in the left para-aortic region. After pretreatment with phenoxybenzamine 30 mg daily, the patient was operated. Patohistology revealed paraganglioma with infiltrative characteristics but no lymph-node metastasis. Three days following the operation she suffered another hypertensive crisis and MRI and repeated MIBG whole-body scan confirmed multiple vertebral metastasis. She was further treated with prazosine (1 mg four times daily) and atenolole (50 mg daily). Three months later a therapeutic dose of 200 mCi of radioactive MIBG was given. Patient had no further hypertensive crisis. Another MIBG treatment is planned. |
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Key words:
Extra-adrenal pheochromocytoma; Paraganglioma; Malignancy |
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