Cancer Res Treat.  2014 Oct;46(4):411-414. 10.4143/crt.2013.093.

A New Approach to the Treatment of Metastatic Paraganglioma: Sorafenib

• Gunaldi M
• Kara IO
• Duman BB
• Afsar CU
• Ergin M
• Avci A

• KMID: 2380379
• DOI: http://doi.org/10.4143/crt.2013.093

Abstract

Paragangliomas are relatively rare chromaffin cell tumors which may be cured through resection. Patients with paragangliomas may develop metastatic diseases. There is no consensus regarding refractory chemotherapy for treatment of metastatic disease. In this report, we presented a case of a 43-year-old woman who was admitted to the hospital with a history of episodic headaches, diaphoresis, and weakness. Elevated plasma catecholamine levels and a right paraaortic mass were observed on computed tomography. The mass was excised, and a diagnosis of paraganglioma was confirmed. After 20 months of follow-up, local recurrence and metastases were detected in the thorax, abdomen, and skeletal system. Plasma and urinary catecholamine levels were high. Chemotherapy was administered, and no improvement was observed. Therefore, following this palliative conventional chemotherapy, sorafenib was administered for three months, and, finally, positron emission tomography showed that the patient's lesions had completely regressed.

Keyword

Extra-adrenal paraganglioma; Neoplasm metastasis; Sorafenib; Pheochromocytomas; Tyrosine kinase inhibitor

MeSH Terms

Abdomen
Adult
Chromaffin Cells
Consensus
Diagnosis
Drug Therapy
Female
Follow-Up Studies
Headache
Humans
Neoplasm Metastasis
Paraganglioma*
Paraganglioma, Extra-Adrenal
Pheochromocytoma
Plasma
Positron-Emission Tomography
Recurrence
Thorax

Figure

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  Fig. 1. Zellballen arrangement of the chief cells with peripherally layered sustentacular cells and a prominent capillary network around each group is noted (H&E staining, ×200).

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  Fig. 2. Positron emission tomography-computed tomography shows metastases.

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  Fig. 3. Positron emission tomography-computed tomography image obtained three months later, after onset of sorafenib therapy, shows regression of all metastases.

Reference

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