Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Effectiveness of 18F-FDG PET/CT in finding lung metastasis from a retroperitoneal paraganglioma

Document Type : Case report

Authors
Tomonori Chikasue 1
Seiji Kurata 1
Shuji Nagata 1
Shuichi Tanoue 1
Akiko Sumi 1
Mizuki Gobaru 2
Toru Hisaka 3
Toshihiro Hashiguchi 4
Takuya Furuta 5
Jun Akiba 5
Kiminori Fujimoto 1
Toshi Abe 1
1 Department of Radiology, Kurume University School of Medicine, Kurume, Japan
2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
3 Department of Surgery, Kurume University School of Medicine, Kurume, Japan
4 Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
5 Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
10.22038/aojnmb.2023.74066.1516
Abstract
A 50-year-old woman was diagnosed with iron deficiency anemia on general medical examination. Further, contrast-enhanced abdominal CT and magnetic resonance imaging revealed a large hypervascular mass with internal degeneration and necrosis in the retroperitoneal space. She was referred to our hospital for further evaluation and treatment. Because the paraganglioma was most likely as the imaging diagnosis, 123I-MIBG scintigraphy was performed. It revealed the marked abnormal accumulation in the retroperitoneal lesion indicating the paraganglioma and no other abnormal accumulation was noted. Several plasma catecholamines and their urinary metabolites were normal. On the subsequent 18F-FDG PET/CT, high FDG uptake was found in the retroperitoneal lesion (SUVmax=38). FDG uptake was also found in a small nodule at the base of the lower lobe of the right lung (SUVmax= 9.8). Contrast-enhanced imaging revealed a hypervascular nodule at the base of the right lung, suggesting pulmonary metastasis of a paraganglioma. The abdominal lesion and right lung nodule were excised, and retroperitoneal paraganglioma and pulmonary metastasis were diagnosed based on the pathology findings. In this case, 18F-FDG PET/CT was useful in the search for paraganglioma metastasis. We report a relationship between 123I-MIBG accumulation and 18F-FDG uptake in paraganglioma and review the relevant literature.
Keywords
Paraganglioma
Retroperitoneal tumor
lung metastasis
123I-MIBG scintigraphy
18F-FDG PET/CT
Subjects
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 12, Issue 1
January 2024
Pages 46-51