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Malignant paraganglioma presenting as a mandibular metastasis
Joel Stanek1, Shifteh Vahidi2, Christopher T Wilke3
1Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
Head & Neck
|January 22, 2019
Summary
This study details a rare case of malignant paraganglioma metastasizing to the mandible. Nuclear medicine imaging was crucial for identifying the primary intra-abdominal lesions in this neuroendocrine tumor.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Pathology
Background:
- Metastatic paragangliomas are rare neuroendocrine tumors with common bony metastases in the ribs, vertebrae, and pelvis.
- Mandibular metastases from paraganglioma are exceptionally rare, with few documented cases.
Observation:
- A 75-year-old female presented with a rapidly enlarging mandibular mass over six months.
- Biopsy confirmed the mandibular mass as a paraganglioma.
Findings:
- 18F-fluorodeoxyglucose positron emission tomography revealed two hypermetabolic intra-abdominal lesions near the inferior vena cava, confirmed as paraganglioma.
- The patient underwent successful surgical resection including left segmental mandibulectomy and neck dissection with reconstruction.
Implications:
- This case highlights the importance of considering rare metastatic patterns in neuroendocrine tumors.
- Nuclear medicine imaging plays a vital role in staging and identifying primary sites of paraganglioma.
- Surgical intervention can be effective for managing mandibular paraganglioma metastases.
