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Updated: May 7, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Sinonasal paraganglioma with long-delayed recurrence and metastases: genetic and imaging findings
Justin Michel1, David Taïeb, Marianne Jolibert
1MD, Department of Otorhinolaryngology, Head and Neck Surgery, LA Timone University Hospital, REFCOR, Aix-Marseille University, 264 rue Saint-Pierre, 13385 Marseille Cedex 5, France. Justin.michel@ap-hm.fr.
Context:
Sinonasal paragangliomas have rarely been reported in the literature. They are often aggressive.
Patient:
We report an original case of sinonasal paragangliomas with a tumor recurrence diagnosed 13 years after resection of the primary tumor. Somatostatin receptor scintigraphy and [18F]-fluorodeoxyglucose positron emission tomography/computed tomography were the most sensitive functional imaging techniques, and they ruled out distant metastases. Interestingly, [18F]-fluorodihydroxyphenylalanine positron emission tomography/computed tomography was negative, a feature that may be considered a sign of functional dedifferentiation. Screening for germline mutations of the SDHB, SDHC, SDHD, SDHAF2, VHL, MAX, and TMEM127 was negative.
Conclusion:
The diagnosis of malignancy remains challenging at initial diagnosis, and patients should be followed during their entire lifetime.
