Gallbladder Paraganglioma Associated with SDHD Mutation: a Potential Pitfall on ¹⁸F-FDOPA PET Imaging
10.1007/s13139-018-0558-1
- Author:
Zahraa Abdul SATER
1
;
Abhishek JHA
;
Adel MANDL
;
Sheila K MANGELEN
;
Jorge A CARRASQUILLO
;
Alexander LING
;
Melissa K GONZALES
;
Osorio LOPES ABATH NETO
;
Markku MIETTINEN
;
Karen T ADAMS
;
Pavel NOCKEL
;
Mustapha EL LAKIS
;
Karel PACAK
Author Information
1. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD 20892, USA.
- Publication Type:Case Report
- Keywords:
Gallbladder;
Paraganglioma;
SDHD;
⁶⁸Ga-DOTATATE;
¹⁸F-DOPA;
¹⁸F-FDG
- MeSH:
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
- From:Nuclear Medicine and Molecular Imaging
2019;53(2):144-147
- CountryRepublic of Korea
- Language:English
-
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 ⁶⁸Ga-DOTATATE PET/CTand retrospectively on ¹⁸F-FDOPA PET/CT but was nonavid on ¹⁸F-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 ¹⁸F-FDOPA PET/CT as its normal excretion occurs through biliary system and gallbladder. This case highlights the superiority of ⁶⁸Ga-DOTATATE in comparison to ¹⁸F-FDOPA and ¹⁸F-FDG in the detection of SDHD-related parasympathetic PGL.ClinicalTrials.gov Identifier: NCT00004847.
