Tomonori Chikasue - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Seiji Kurata - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Shuji Nagata - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Shuichi Tanoue - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Akiko Sumi - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Mizuki Gobaru - Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
Toru Hisaka - Department of Surgery, Kurume University School of Medicine, Kurume, Japan
Toshihiro Hashiguchi - Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
Takuya Furuta - Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
Jun Akiba - Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
Kiminori Fujimoto - Department of Radiology, Kurume University School of Medicine, Kurume, Japan
Toshi Abe - Department of Radiology, Kurume University School of Medicine, Kurume, Japan

A ۵۰-year-old woman was diagnosed with iron deficiency anemia on general medical examination. Further, contrast-enhanced abdominal CT and magnetic resonance imaging revealed a large hypervascular mass with internal degeneration and necrosis in the retroperitoneal space. She was referred to our hospital for further evaluation and treatment. Because the paraganglioma was most likely as the imaging diagnosis, ۱۲۳I-MIBG scintigraphy was performed. It revealed the marked abnormal accumulation in the retroperitoneal lesion indicating the paraganglioma and no other abnormal accumulation was noted. Several plasma catecholamines and their urinary metabolites were normal. On the subsequent ۱۸F-FDG PET/CT, high FDG uptake was found in the retroperitoneal lesion (SUVmax=۳۸). FDG uptake was also found in a small nodule at the base of the lower lobe of the right lung (SUVmax= ۹.۸). Contrast-enhanced imaging revealed a hypervascular nodule at the base of the right lung, suggesting pulmonary metastasis of a paraganglioma. The abdominal lesion and right lung nodule were excised, and retroperitoneal paraganglioma and pulmonary metastasis were diagnosed based on the pathology findings. In this case, ۱۸F-FDG PET/CT was useful in the search for paraganglioma metastasis. We report a relationship between ۱۲۳I-MIBG accumulation and ۱۸F-FDG uptake in paraganglioma and review the relevant literature.

paraganglioma, retroperitoneal tumor, lung metastasis, ۱۲۳I-MIBG scintigraphy, ۱۸F-FDG PET/CT