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Gallbladder Paraganglioma Associated with SDHD Mutation: a Potential Pitfall on ¹⁸F-FDOPA PET Imaging / 핵의학분자영상
Nuclear Medicine and Molecular Imaging ; : 144-147, 2019.
Article in English | WPRIM | ID: wpr-786457
ABSTRACT
A 36-year-old male patient initially presented with hypertension, tinnitus, bilateral carotid masses, a right jugular foramen, and a periaortic arch mass with an elevated plasma dopamine level but an otherwise normal biochemical profile. On surveillance MRI 4 years after initial presentation, he was found to have a 2.2-cm T2 hyperintense lesion with arterial enhancement adjacent to the gallbladder, which demonstrated avidity on ⁶⁸Ga-DOTATATE PET/CTand retrospectively on ¹⁸F-FDOPA PET/CT but was nonavid on ¹⁸F-FDG PET/CT. Biochemical work-up including plasma catecholamines, metanephrines, and chromogranin A levels were found to be within normal limits. This lesion was surgically resected and was confirmed to be a paraganglioma (PGL) originating from the gallbladder wall on histopathology. Pheochromocytoma (PHEO) and PGL are rare tumors of the autonomic nervous system. Succinate dehydrogenase subunit D (SDHD) pathogenic variants of the succinate dehydrogenase complex are usually involved in parasympathetic, extra-adrenal, multifocal head, and neck PGLs. We report an unusual location of PGL in the gallbladder associated with SDHD mutation which could present as a potential pitfall on ¹⁸F-FDOPA PET/CT as its normal excretion occurs through biliary system and gallbladder. This case highlights the superiority of ⁶⁸Ga-DOTATATE in comparison to ¹⁸F-FDOPA and ¹⁸F-FDG in the detection of SDHD-related parasympathetic PGL.ClinicalTrials.gov Identifier NCT00004847.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Paraganglioma / Pheochromocytoma / Plasma / Autonomic Nervous System / Succinate Dehydrogenase / Tinnitus / Biliary Tract / Magnetic Resonance Imaging / Catecholamines / Dopamine Type of study: Observational study / Risk factors Limits: Adult / Humans / Male Language: English Journal: Nuclear Medicine and Molecular Imaging Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Paraganglioma / Pheochromocytoma / Plasma / Autonomic Nervous System / Succinate Dehydrogenase / Tinnitus / Biliary Tract / Magnetic Resonance Imaging / Catecholamines / Dopamine Type of study: Observational study / Risk factors Limits: Adult / Humans / Male Language: English Journal: Nuclear Medicine and Molecular Imaging Year: 2019 Type: Article