Nucl Med Mol Imaging.
2019 Apr;53(2):144-147. 10.1007/s13139-018-0558-1.
Gallbladder Paraganglioma Associated with SDHD Mutation: a Potential Pitfall on ¹â¸F-FDOPA PET Imaging
- Affiliations
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- 1National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD 20892, USA.
- 2Section on Medical Neuroendocrinology, Developmental Endocrine Oncology and Genetics Affinity Group, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Dr. MSC-1109, Bldg. 10, CRC, 1E-3140, Bethesda, MD 20892, USA. karel@mail.nih.gov
- 3Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, MD 10065, USA.
- 4Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD 20892, USA.
- 5Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD 20892, USA.
- KMID: 2448102
- DOI: http://doi.org/10.1007/s13139-018-0558-1
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 â¶â¸Ga-DOTATATE PET/CTand retrospectively on ¹â¸F-FDOPA PET/CT but was nonavid on ¹â¸F-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 ¹â¸F-FDOPA PET/CT as its normal excretion occurs through biliary system and gallbladder. This case highlights the superiority of â¶â¸Ga-DOTATATE in comparison to ¹â¸F-FDOPA and ¹â¸F-FDG in the detection of SDHD-related parasympathetic PGL. ClinicalTrials.gov Identifier: NCT00004847.
Keyword
MeSH Terms
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Adult
Autonomic Nervous System
Biliary Tract
Catecholamines
Chromogranin A
Dopamine
Gallbladder*
Head
Humans
Hypertension
Magnetic Resonance Imaging
Male
Neck
Paraganglioma*
Pheochromocytoma
Plasma
Positron-Emission Tomography and Computed Tomography
Retrospective Studies
Succinate Dehydrogenase
Tinnitus
Catecholamines
Chromogranin A
Dopamine
Succinate Dehydrogenase
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