From the *Department of Biophysics and Nuclear Medicine, Strasbourg University Hospitals, Strasbourg; †ICube, University of Strasbourg/CNRS (UMR 7357) and Fédération de Médecine Translationnelle de Strasbourg, Faculty of Medicine, Strasbourg; ‡Departments of Pathology and §General Surgery, Strasbourg University Hospitals, Strasbourg; ¶Molecular Biology Laboratory, Conception University Hospital, Marseille; and ∥Department of Internal Medicine, Strasbourg University Hospitals, Strasbourg, France.
Clin Nucl Med. 2014 Oct;39(10):892-3. doi: 10.1097/RLU.0000000000000374.
A 62-year-old patient presented with mildly elevated catecholamines and an abdominal painless mass. Abdominal CT revealed an 18 × 12 cm tumor in the right retroperitoneum with intense contrast enhancement. Somatostatin receptor scintigraphy (SRS) showed pathologic uptake by the lesion. Given the suspicion of paraganglioma, the patient was referred to surgery for tumor removal. Surprisingly, the histopathological examination revealed a dedifferentiated liposarcoma. Somatostatin receptors of type 2 were identified and quantified by reverse transcription polymerase chain reaction. The unexpected presentation of our patient draws clinicians' attention when performing diagnostic procedure for retroperitoneal lesions, even though hormone secretion and positive SRS strongly suggest paraganglioma.
一位 62 岁的患者表现为儿茶酚胺轻度升高和腹部无痛性肿块。腹部 CT 显示右腹膜后有一个 18×12cm 的肿瘤,对比增强明显。生长抑素受体闪烁显像(SRS)显示病变有病理摄取。由于怀疑为副神经节瘤,患者被转介手术切除肿瘤。令人惊讶的是,组织病理学检查显示为去分化脂肪肉瘤。通过逆转录聚合酶链反应鉴定和定量了 2 型生长抑素受体。当对腹膜后病变进行诊断性检查时,我们的患者的这种意外表现引起了临床医生的注意,尽管激素分泌和 SRS 阳性强烈提示为副神经节瘤。