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Journal of Nuclear Cardiology

, Volume 16, Issue 4, pp 644–647 | Cite as

Multimodality imaging of an unusual case of cardiac paraganglioma

  • Deepak Thomas
  • Frederick D. Grant
  • Raymond Kwong
  • Vania Nose
  • Marcelo F. Di Carli
  • Sharmila DorbalaEmail author
Nuclear Cardiology Bullet

Case presentation

A 32-year-old female presented to another hospital with symptoms of nausea, vomiting, and headache, and was found to be hypertensive with orthostasis. Laboratory evaluation suggested the diagnosis of pheochromocytoma with elevated levels of serum metanephrines and nor-metanephrines. Before presentation to the hospital, she was not on any regular medications. Extensive cross-sectional and nuclear medicine imaging, including a head and neck CT, non-contrast CT and MRI of the abdomen and neck, 123I-meta-iodobenzylguanidine (123I-MIBG) whole-body scan, and exploratory surgery of the neck were unrevealing.

Upon transfer to our institution, whole-body 18F-fluoro-2-deoxy-glucose positron emission tomography with CT ( 18F-FDG-PET/CT) scan done after 6 h of fasting demonstrated a 3.5 × 3.0 cm 2 FDG-avid soft tissue mass adjacent to the right heart (Figure  1). On a whole-body 111In-octreotide scan, subtle uptake at this location was not considered diagnostic due to its proximity...

Keywords

Octreotide Cardiac Magnetic Resonance Paraganglioma Metanephrines Physiological Uptake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 1

A transthoracic 2-dimensional echocardiogram (Apical 4 chamber and sub-costal views) showing the para-cardiac mass in the region of the right atrioventricular groove (AVI 1760 kb)

Video 2

A transthoracic 2-dimensional echocardiogram (Apical 4 chamber and sub-costal views) showing the para-cardiac mass in the region of the right atrioventricular groove (AVI 2615 kb)

12350_2009_9067_MOESM3_ESM.avi (2 mb)
Video 3 Cardiac magnetic resonance imaging demonstrating the mass (33x31 mm diameter) in the right AV groove (AVI 2030 kb)

References

  1. 1.
    Erickson D, Kudva YC, Ebersold MJ, Thompson GB, Grant CS, Van Heerden JA, et al. Benign paragangliomas: Clinical presentation and treatment outcomes in 236 patients. J Clin Endocrinol Metab 2001;86:5210-6.CrossRefPubMedGoogle Scholar
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    Maxey TS, Grow P, Morris CD, Patton KT, Guyton RA. Biatrial primary cardiac paraganglioma: A rare finding. Cardiovasc Pathol 2007;16:179-82.CrossRefPubMedGoogle Scholar
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    Martin WH, Delbeke D, Patton JA, Sandler MP. Detection of malignancies with SPECT versus PET, with 2-[fluorine-18]fluoro-2-deoxy-d-glucose. Radiology 1996;198(1):225-31.PubMedGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2009

Authors and Affiliations

  • Deepak Thomas
    • 1
  • Frederick D. Grant
    • 1
    • 4
  • Raymond Kwong
    • 2
  • Vania Nose
    • 3
  • Marcelo F. Di Carli
    • 1
    • 2
    • 4
  • Sharmila Dorbala
    • 1
    • 2
    • 4
    Email author
  1. 1.Division of Nuclear Medicine and Molecular Imaging, Department of RadiologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and RadiologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  3. 3.Department of PathologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  4. 4.Joint Program in Nuclear MedicineHarvard Medical SchoolBostonUSA

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