Octreotide scintigraphy for the detection of paragangliomas

Paragangliomas are neuroendocrine tumors located primarily in the head and neck region, but they can also occur at other sites. Confirming the preoper ative diagnosis and detecting synchronous tumors may be difficult in some p atients. Octreotide is a somatostatin analog that, when coupled to a radioi sotope, produces a scintigraphic image of tumors expressing somatostatin ty pe 2 receptors. Paragangliomas, like many neuroendocrine tumors, have been found to have a high density of somatostatin type 2 receptors on the cell s urface. This study compared the results of preoperative octreotide scintigr aphy with the histopathology in 21 patients who underwent surgery for presu med head and neck paragangliomas. Octreotide scan findings were positive in 16 patients with paragangliomas and negative in 3 patients with other path ology. One false-positive and 1 false-negative result were obtained. Thus, this test had an accuracy of 90%, a sensitivity of 94%, and a specificity o f 75%. Previously unidentified synchronous tumors were identified in 5 pati ents. On the basis of this series of patients, octreotide scintigraphy appe ars to be a reliable test to detect paragangliomas and may be quite helpful in preoperative planning.