Endocrine Abstracts

Pheochromocytomas and abdominal paragangliomas are catecholamine-producing tumors of the sympathetic nervous system, while head and neck paragangliomas are non-secreting tumors of parasympathetic origin.

Here we present a case of 20-year-old patient with the metastases of malignant paraganglioma. In 2004 the disease has been detected at accidental abdominal sonography. Patient has not had any symptoms, such as headache, hyperhidrosis, palpitation, weight loss, dysphagia or hoarseness of voice. Blood pressure was normal. Abdominal MRI sc an revealed a 4×7 cm mass of left adrenal gland and nodes on abdominal aorta. The initial laboratory tests were normal. However, hypersecretion of catecholamine were observed.

The immunohistochemical analyze of postsurgical sample of tissue revealed malignancy paraganglioma. The post-surgical outcome of patient showed normal level of catecholamine. After surgical treatment (resection of the left suprarenal gland and local lymph nodes on abdominal aorta) diagnostic 131J-MIBG scintigraphy showed pathological uptake on the right side, but not certainly on the liver. The liver and suprarenal MRI scan showed no pathological change.

There were no signs of tumor recurrence after one year, except the above mentioned pathological MIBG uptake which is still persisting. The treatment by vascular surgeon is recommended.