Visualisation of a paraganglioma by technetium-99m-sestamibi scintigraphy

A 68-yr-old woman presented to our observation with multinodular goiter and a contiguous right laterocervical mass. In spite of ultrasound, technetium and iodine scan, CT and fine-needle biopsy, the precise origin of the mass remained uncertain. On additional multi-phase sestamibi scan, the neck reg ion showed an early high uptake rapidly decreasing over time in the lateroc ervical mass, and a persistent inhomogeneous distribution in the thyroid gl and. This behavior suggested that the laterocervical mass could derive from an anatomical structure other than the thyroid. Surgical exploration estab lished the extrathyroid nature of the laterocervical mass and the histologi cal examination confirmed that it was a typical paraganglioma. This finding is in keeping with a recent report of positive sestamibi uptake in a cervi cal paraganglioma, although our case showed a more rapid kinetic. This tumo r should be therefore taken into consideration in the differential interpre tation of focal sestamibi uptake. (J. Endocrinol. Invest. 22: 296-300, 1999 ) (C)1999, Editrice Kurtis.