Multiple recurring paragangliomas: A problem of diagnosis and location. Case report and review of the literature

Rationale. Paragangliomas constitute a particular diagnostic challenge beca use of the difficulties involved in identifying new lesions. Case report. T he findings in the case of a young woman with multiple recurring paragangli omas which reappeared eleven years after successful surgical treatment are presented. Discussion. This case illustrates the diagnostic difficulties of this pathologic entity and the lack of a technique of sufficient sensitivi ty to reveal the existence of one or more tumors with or without hormonal s ecretion, their location and rate of growth and the number of neoplasias to avoid as many surgical interventions as possible. Inasmuch as an ideal tec hnique for diagnosis and localization of this type of tumor remains to be d eveloped, non-invasive methods, particularly I-131 MIBG scintigraphy, play a significant role in evaluation because of their high sensitivity for dete cting chromaffin tissue, especially in extra-adrenal locations. Conclusion. Periodic long-term radionuclide scanning should be recommended for all asy mptomatic patients given the risk of residual and/or reactivating tumoral t issue with benign or metastatic behavior.