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1.
Isr Med Assoc J ; 22(1): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927807

RESUMO

BACKGROUND: Primary retroperitoneal neoplasms (PRN) arise from diverse retroperitoneal tissues. Soft tissue sarcomas (STS) comprise the majority and are well studied. Other non-sarcomatous PRN are very rare and less familiar. OBJECTIVES: To evaluate the clinicopathologic and radiologic features of non-sarcomatous PRN, as well as the outcome of complete tumor resection (TR). METHODS: Retrospective data were collected on consecutive patients (June 2006 to January 2015) who underwent resection of retroperitoneal lesions at our department. Final pathology of non-sarcomatous PRN was included. RESULTS: The study population included 36 patients (26% with PRN). PRN were neurogenic (17%), fat-containing (3%), and cystic (6%). The preoperative diagnosis was correct in only 28%. All patients underwent TR via laparotomy (72%) or laparoscopy (28%), for mean operative time of 120 ± 46 minutes. En bloc organ resection was performed in 11%. Complete TR was achieved in 97%. Intra-operative spillage occurred in 8%. Intra-operative, 90-day postoperative complications, and mortality rates were 11%, 36%, and 0%, respectively. The mean length of stay was 6.5 ± 5.5 days. The median overall survival was 53 ± 4.9 months. CONCLUSIONS: Familiarity with radiologic characteristics of PRN is important for appropriate management. Counter to STS, other PRN are mostly benign and have an indolent course. Radical surgery is not required, as complete TR confers good prognosis. Expectant management is reserved for small, asymptomatic, benign neoplasms.


Assuntos
Neoplasias Retroperitoneais/diagnóstico , Idoso , Feminino , Ganglioneuroma/diagnóstico , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/patologia , Ganglioneuroma/cirurgia , Humanos , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/diagnóstico por imagem , Neurofibroma/patologia , Neurofibroma/cirurgia , Paraganglioma/diagnóstico , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
3.
Radiologe ; 59(11): 975-981, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31338528

RESUMO

CLINICAL BACKGROUND: If pheochromocytoma (PC) or paraganglioma (PGL) is diagnosed based on serologic studies, imaging is required to locate the adrenal mass for further management. Besides pathognomonic hormonal findings, PC/PGL can exhibit typical imaging features. However, PC/PGL can also show morphological overlap with other pathologies. STANDARD RADIOLOGICAL METHODS: The modality of choice for evaluation of PC is CT. In case of extra-adrenal location, MRI is superior to CT. Imaging with PET-CT provides complementary information in the differentiation of PC/PGL and is recommended as the imaging modality of choice for malignant PC/PGL. 68Ga-DOTATATE (or 68Ga-DOTATOC/ 68Ga-DOTANOC) PET-CT has high sensitivity for SDHx-mutated PC/PGL and serves for planning of radioreceptor therapy with somatostatin analogues. In contrast, 123I-metaiodobenzylguanidine (MIBG) scintigraphy is important in assessing the potential efficacy of radioreceptor therapy with MIBG. METHODICAL DETAILS: The CT protocol for PC evaluation should include non-enhanced, arterial, portal-venous and late phases; the latter for the evaluation of wash-out. Recent studies indicate non-enhanced CT alone may be sufficient to rule out PC. For MRI, in- and opposed-phase sequences should be additionally acquired. PRACTICAL RECOMMENDATIONS: A relevant proportion of PC is diagnosed incidentally. Therefore, imaging of PC will gain further importance. Recent studies show better response rates of PC/PGL after radioreceptor therapy with somatostatin analogues (177Lu-DOTATATE) than with MIBG. Therefore, 68Ga-DOTATATE PET-CT gains further importance-for diagnostic imaging and therapy planning.


Assuntos
Neoplasias das Glândulas Suprarrenais , Paraganglioma , Feocromocitoma , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Tomografia por Emissão de Pósitrons/métodos , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Paraganglioma/diagnóstico por imagem , Feocromocitoma/diagnóstico por imagem
4.
Hell J Nucl Med ; 22(2): 142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31273358

RESUMO

Dear Editor, In this journal, a few years ago, we presented a Bayesian (critical) appraisal of the-then recent-American Endocrine Society's guidelines regarding the diagnosis and management of pheochromocytoma/paraganglioma (PPG). This year, the European Society of Nuclear Medicine and the Society of Nuclear Medicine and Molecular Imaging have introduced new guidelines regarding functional imaging (i.e. by means of Nuclear Medicine modalities) of PPG. In light of this, we believe that it is appropriate to present a new relevant Bayesian assessment. In the new guidelines the following functional imaging modalities are covered: iodine-123-metaiodobenzylguanidine (123I-MIBG) single photon emission tomography (SPET), indium-111-diethylenetriamine pentaacetic acid (111In-DTPA)-pentetreotide (111In-pentetreotide) SPET, fluorine-18-fluorodihydroxyphenylalanine (18F-FDOPA) positron emission tomography (PET), 18F-fluorodeoxyglucose (18F-FDG) PET and PET with various gallium-68-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (168Ga-DOTA)-coupled somatostatin agonists (68Ga-SSTa). Based on a pretest probability of 15% for extra-adrenal disease and the reported sensitivity and specificity for each modality, we calculated likelihood ratios (LR) for a positive and a negative test (LR+ and LR-, respectively). In the absence of a given specificity in the guidelines we used levels of 55% for 18F-FDG and 85% for 68Ga-SSTa (the latter is a level that we used in our previous assessment), which have been validated in a recent meta-analysis. Using LR+ and LR- with Fagan's nomograms we calculated the post-test probability of extra-adrenal PPG. Only the LR+ for 18F-FDOPA was over 10 and no LR- was lower than 0.1, shifting to an important degree the probability of a diagnosis (clinicians have to bear in mind that an LR- may not be useful, since absence of radionuclide uptake does not imply absence of PPG if biochemistry is positive). It is evident that functional imaging of PPG has become more diversified and tailored according to each patient's history and genetic background. Nevertheless, the diagnostic characteristics of all methods (biochemical and imaging) are still not perfect; they are rather complimentary to each other. Biochemical evaluation should be done first, since functional imaging of PPG is advised to be performed in patients with biochemically-proven disease.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Paraganglioma/diagnóstico por imagem , Feocromocitoma/diagnóstico por imagem , Guias de Prática Clínica como Assunto , Teorema de Bayes , Humanos , Medicina Nuclear
5.
Clin Nucl Med ; 44(9): 750-751, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31283610

RESUMO

We present a case of a right skull base paraganglioma detected using F-choline PET/CT in a 63-year-old man. The F-choline PET/CT scan was performed to assess a known prostate cancer. In addition, the scan demonstrated a mildly choline-avid (SUVmax, 3.8) tumor within the carotid sheath of the right skull base, extending through the jugular foramen to the cerebellomedullary and cerebellopontine angles. F-choline may provide a superior alternative to FDG in imaging paragangliomas of the skull base because, unlike FDG, there is no significant F-choline uptake in the adjacent brain.


Assuntos
Colina/análogos & derivados , Paraganglioma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Base do Crânio/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
6.
Clin Nucl Med ; 44(9): e517-e518, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31348093

RESUMO

Paratesticular paragangliomas are a rare occurrence. We present the case of a 43-year-old man who presented with paresthesia and paraparesis and was found to have pathologic fracture involving D1 vertebra as a manifestation of metastasis from a nonsecretory right paratesticular paraganglioma.


Assuntos
Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/patologia , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Metástase Neoplásica
7.
J Clin Neurosci ; 66: 7-11, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31153748

RESUMO

Paragangliomas (PGs) are rare tumours with a reported estimated annual incidence of up to 3 per million. Spinal involvement may possible with spinal metastasis and primary extradural localizations. The aim of this paper is to evaluate clinical outcomes of surgical treatment of a rare disease that can involve the spine and that should be considered in the differential diagnosis of spinal injuries. This is a retrospective observational study of the spinal paragangliomas treated at our institute. Five patients have been enrolled: three with metastatic PG and two with extradural PG. Metastatic PGs were treated with intralesional excision plus adjuvant therapies instead, extradural PGs with intralesional excision without adjuvant therapies. Among patients affected by metastastic paraganglioma two patients were Alive with disease (AWD) at the latest follow and one patient died for the spreading of disease at 240 months after surgery. Two patients with extradural paraganglioma of thoracic spine were AWD at the latest follow-up without pain and neurological deficits. Surgical management of spinal localizations can represent a challenge. Surgery has a main role in both diseases where intralesional excision plus adjuvant therapies seems to be able to achieve the local control and a satisfying prognosis in case of undisseminated tumour.


Assuntos
Paraganglioma/diagnóstico por imagem , Paraganglioma/terapia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/terapia , Adolescente , Adulto , Estudos de Coortes , Terapia Combinada/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paraganglioma/secundário , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/secundário
8.
Int J Mol Sci ; 20(11)2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31185588

RESUMO

A syndrome of multiple paragangliomas/pheochromocytomas, somatostatinoma, and polycythemia due to somatic mosaic gain-of-function mutation of EPAS1, encoding HIF-2α, was previously described. HIF-2α has been implicated in endochondral and intramembranous ossification. Abnormal bone growth of the skull base may lead to Chiari malformation type I. We report two cases of EPAS1 gain-of-function mutation syndrome with Chiari malformation and developmental skull base anomalies. Patients were referred to the Section on Medical Endocrinology, Eunice Kennedy Shriver NICHD, NIH for evaluation of recurrent and metastatic paragangliomas or pheochromocytoma. The syndrome was confirmed genetically by identification of the functional EPAS1 gain-of-function mutation in the resected tumors and circulating leukocytes. Both patients were confirmed for characteristics of EPAS1 gain-of-function mutation syndrome by complete blood count (CBC), plasma biochemistry, and computed tomography (CT) of the abdomen and pelvis. Chiari malformation type I and abnormal bony development of the posterior fossa was found on MRI and CT of the head. The present study implicates EPAS1 mutations in abnormal posterior fossa development resulting in Chiari malformation type I.


Assuntos
Malformação de Arnold-Chiari/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Anormalidades Craniofaciais/genética , Paraganglioma/genética , Adulto , Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/patologia , Anormalidades Craniofaciais/diagnóstico por imagem , Anormalidades Craniofaciais/patologia , Feminino , Mutação com Ganho de Função , Humanos , Masculino , Pessoa de Meia-Idade , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Síndrome
9.
BMJ Case Rep ; 12(6)2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31229970

RESUMO

We describe the case of a 35-year-old man with focal epilepsy since age 16. Due to a refractory course, several treatments were tried over the years, including insertion of a deep brain stimulator. At the time of his first assessment at our unit, he had recently been diagnosed with hypertension. An MR scan of brain revealed multiple T2 hyperintense white matter lesions, and evidence of previous haemorrhage in the left basal ganglia and pons. On follow-up imaging, the changes were considered to be in keeping with hypertensive arteriopathy. He was referred for further assessment of his hypertension and was found to have a para-aortic paraganglioma. This was excised 16 months after his initial presentation to us. The surgery was associated with an improvement in his seizure control. This case serves as a reminder of the need to be vigilant about the possibility of coexisting conditions in people with epilepsy.


Assuntos
Neoplasias Encefálicas/patologia , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Hipertensão/diagnóstico por imagem , Paraganglioma/patologia , Substância Branca/patologia , Adulto , Anticonvulsivantes , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Epilepsia Resistente a Medicamentos/fisiopatologia , Epilepsia Resistente a Medicamentos/cirurgia , Humanos , Hipertensão/etiologia , Hipertensão/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Paraganglioma/diagnóstico por imagem , Paraganglioma/cirurgia , Resultado do Tratamento , Substância Branca/diagnóstico por imagem , Substância Branca/cirurgia
10.
Pan Afr Med J ; 32: 62, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223354

RESUMO

Malignant paragangliomas pose a real challenge for the practitioners. They are rare complex tumors, very heterogeneous in their evolution and prognosis. Given the rarity of this tumor group, there is no consensus on therapeutic management. Through this illustrative case study, we report the case of a 29 year old female patient followed for malignant paraganglioma due to which she initially had surgery. After a six month interval, multifocal recurrence was detected on Octreoscan PET-CT (Positron Emission Tomography- Computer Tomography). The patient underwent monthly injection of Somatuline for one year and then discontinued therapy due to disease progression. Cytoreduction was then performed followed by radiotherapy. After a year, the patient had massive disease progression. Dacarbazine-based chemotherapy was initiated. The patient had an almost complete metabolic response after eight cycles. This study aims to highlight the different therapeutic options in the management of malignant paragangliomas.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Paraganglioma/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Adulto , Terapia Combinada , Procedimentos Cirúrgicos de Citorredução/métodos , Dacarbazina/administração & dosagem , Feminino , Humanos , Recidiva Local de Neoplasia , Paraganglioma/diagnóstico por imagem , Peptídeos Cíclicos/administração & dosagem , Somatostatina/administração & dosagem , Somatostatina/análogos & derivados , Resultado do Tratamento
11.
Cir Pediatr ; 32(2): 109-112, 2019 Apr 22.
Artigo em Espanhol | MEDLINE | ID: mdl-31056873

RESUMO

INTRODUCTION: Pheochromocytoma is an infrequent neuroendocrine tumor, originated from neural crest cells. 10% of them are extra adrenal, located at sympathetic nodules and are known as paragangliomas. The most common place is the Zuckerkandl organ, 10 to 26% are malign and has a mortality around de 26% of the cases. CASE REPORT: We present two cases of teenagers with Zuckerkandl's organ paraganglioma, who debut with high blood pressure, diaphoresis and dyspnea. Complete tumor resection was performed in both cases, during which they presented hipertensive crisis and, after vascular pedicle ligation, hypotension. CONCLUSIONS: Zuckerkandl's organ paraganglioma is a rare pathology in pediatric population, therefore represents an important diagnostic and therapeutic challenge. Surgery differs from other tumors because of catecholamine secretion that produces hemodynamic changes and demands prompt and accurate management from surgeon and anesthetist.


Assuntos
Glomos Para-Aórticos , Paraganglioma , Adolescente , Humanos , Hipertensão/etiologia , Masculino , Paraganglioma/complicações , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Paraganglioma/cirurgia
13.
Clin Nucl Med ; 44(6): e398-e400, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31021911

RESUMO

Head and neck paragangliomas are rare and often asymptomatic tumors and mostly present as painless masses. We describe Ga PSMA 11 PET/CT and Ga DOTANOC PET/CT findings of a 40 year old man with triple head and neck paragangliomas with emphasis on exploring the possible theranostic options.


Assuntos
Antígenos de Superfície/metabolismo , Ácido Edético/análogos & derivados , Glutamato Carboxipeptidase II/metabolismo , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/metabolismo , Oligopeptídeos , Paraganglioma/diagnóstico por imagem , Paraganglioma/metabolismo , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adulto , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino
14.
Clin Nucl Med ; 44(6): e420-e422, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31021914

RESUMO

We present a case of biopsy-proven prostatic adenocarcinoma with a tracer-avid left paravertebral location at D4 to D5 vertebrae, suggestive of metastasis. However, in view of uncommon location of single-site metastasis at paravertebral region with no tracer-avid regional lymphadenopathy, image-guided biopsy was done, which was suggestive of paraganglioma. Ga-PSMA is known to have variable tracer avidity in multiple nonprostatic benign as well as malignant lesions, and our case adds to the list of nonspecific uptake by this once considered "specific" to prostate PET radiotracer.


Assuntos
Adenocarcinoma/patologia , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Paraganglioma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/patologia , Adenocarcinoma/diagnóstico por imagem , Idoso , Biópsia , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Glicoproteínas de Membrana/metabolismo , Compostos Organometálicos/metabolismo , Paraganglioma/secundário , Neoplasias da Próstata/diagnóstico por imagem , Compostos Radiofarmacêuticos/metabolismo
15.
Clin Nucl Med ; 44(5): e370-e371, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30888990

RESUMO

We report the case of a 27-year-old woman referred to our department for the characterization of a 7 × 6-cm left ischio-anal fossa mass by Ga-DOTATOC PET/CT. Several diagnoses were previously mentioned, in particular, myxoid sarcoma but also pelvic paraganglioma. Urinary methoxylated derivates and blood chromogranin A tests were negative. PET/CT showed a high Ga-DOTATOC uptake of the mass that was strongly consistent with paraganglioma diagnosis. Histopathological analysis surprisingly revealed a solitary fibrous tumor without aggressive criteria.


Assuntos
Paraganglioma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Retroperitoneais/diagnóstico por imagem , Tumores Fibrosos Solitários/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Octreotida/análogos & derivados , Compostos Organometálicos , Compostos Radiofarmacêuticos
17.
World Neurosurg ; 126: 399-404, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30831293

RESUMO

BACKGROUND: Paraganglioma in cavernous sinus is a rare entity often misdiagnosed as meningioma or schwannoma on radiology. The embryological origin, from cells of neural crest, does not explain the location per se. Because of its highly vascular nature and close proximity to the carotid artery, surgical excision is a challenge. We herein report the first case of cavernous sinus paraganglioma, without the characteristic "salt and pepper appearance," excised near completely by the subtemporal approach. CASE DESCRIPTION: A 30-year-old woman without a history of any comorbid conditions, particularly hypertension, presented with a 6-month history of progressive headache and double vision. She exhibited upward gaze palsy and hypoesthesia over the right half of her face. There was no papilledema and proptosis. Radiologic imaging revealed an extra-axial T1-weighted isointense, T2-weighted hyperintense lesion with homogenous intense contrast uptake in right parasellar region encasing cavernous internal carotid artery. Furthermore, the tumor was extending along the superior orbital fissure. Suspecting a cavernous sinus meningioma, we performed near-total excision via a subtemporal approach. Postoperative recovery was uneventful, and patient was discharged on fifth postoperative day. The histopathology and immunohistochemistry were consistent with paraganglioma. The patient underwent adjuvant radiotherapy and is under our outpatient follow-up. CONCLUSIONS: Paraganglioma must be considered in the differential diagnosis of parasellar tumors, even when secretory symptoms are absent. The radiologic findings are obscure, and it is difficult to differentiate it from more common tumors of this region such as meningioma, schwannoma, and pituitary adenoma. Surgical excision followed by radiotherapy is the mainstay of management.


Assuntos
Seio Cavernoso/diagnóstico por imagem , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Paraganglioma/diagnóstico por imagem , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Seio Cavernoso/patologia , Diagnóstico Diferencial , Feminino , Humanos , Meningioma/patologia , Paraganglioma/patologia
18.
World Neurosurg ; 125: 32-36, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30703592

RESUMO

BACKGROUND: Differential diagnosis of sellar masses includes adenoma, meningioma, craniopharyngioma, and metastasis. Primary paraganglioma is seldom considered. We present a case of this unique pathology, review the relevant literature, and compile a compendium of immunohistochemical characteristics for use as a resource. CASE DESCRIPTION: A 73-year-old woman presented to the hospital with visual changes in her left hemifield. Noncontrast head computed tomography demonstrated a large sellar mass with suprasellar extension and displacement of the optic chiasm (diameter of 3.1 cm). Magnetic resonance imaging was unobtainable owing to an incompatible pacemaker. Computed tomography characterization was most consistent with a macroadenoma. Given the acute visual decline, surgical decompression via an endonasal transsphenoidal route was performed without complication. A diagnosis of paraganglioma was made based on histopathology. Following resection, the patient's visual field deficit improved. Computed tomography body imaging was negative for a metastatic origin. CONCLUSIONS: Paraganglioma is a rare but potential differential diagnosis to consider when evaluating sellar masses.


Assuntos
Adenoma/diagnóstico por imagem , Quiasma Óptico/diagnóstico por imagem , Paraganglioma/diagnóstico por imagem , Neoplasias Hipofisárias/diagnóstico por imagem , Sela Túrcica/diagnóstico por imagem , Adenoma/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Quiasma Óptico/química , Quiasma Óptico/cirurgia , Paraganglioma/cirurgia , Neoplasias Hipofisárias/cirurgia , Sela Túrcica/química , Sela Túrcica/cirurgia
19.
Gynecol Endocrinol ; 35(7): 567-570, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30786782

RESUMO

Paragangliomas are tumors that originate from the extra-adrenal neural crest, the incidence of which during pregnancy is not more than two to eight cases per million people per year and are known to be highly morbid. The purpose of this report is to describe the experience and results obtained during management of a primigravida diagnosed with paraganglioma on week 21.2 and received both medical and surgical management with good maternal and perinatal outcomes. This case report evidences the importance of practicing interdisciplinary management of patients with clinical suspicion of paragangliomas or pheochromocytomas during pregnancy at high-complexity centers even in a medium-income country.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Paraganglioma/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/patologia , Resultado do Tratamento , Adulto Jovem
20.
Kyobu Geka ; 72(2): 108-111, 2019 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-30772875

RESUMO

Pigmented paraganglioma of the anterior mediastinum is extremely rare. We report a 72-year-old female patient who was pointed out an anterior mediastinum tumor showed by chest computed tomography(CT) scan during a medical check up. The tumor was 50×35 mm showing gradual enlargement and was slightly homogenously contrasted by CT scan and magnetic resonance imaging(MRI). During the resection of the tumor, sudden elevations of both blood pressure up to 205 mmHg and tachycardia up to 131 beat per minate(bpm)was noted on tumor manipulation. Pathologically, the tumor was diagnosed as pigmented paraganglioma with adjacent lymph node metastasis and microscopic extracapsular invasion. The patient is well 5 years post-surgery without recurrence.


Assuntos
Neoplasias do Mediastino/patologia , Paraganglioma/patologia , Idoso , Feminino , Humanos , Hipertensão/etiologia , Complicações Intraoperatórias/etiologia , Metástase Linfática , Imagem por Ressonância Magnética , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Mediastino/diagnóstico por imagem , Invasividade Neoplásica , Recidiva Local de Neoplasia , Paraganglioma/diagnóstico por imagem , Paraganglioma/cirurgia , Taquicardia/etiologia , Tomografia Computadorizada por Raios X
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