array:23 [ "pii" => "S225380892400034X" "issn" => "22538089" "doi" => "10.1016/j.remnie.2024.500018" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "500018" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2024;43:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S2253808924000351" "issn" => "22538089" "doi" => "10.1016/j.remnie.2024.500019" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "500019" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2024;43:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "<span class="elsevierStyleSup">99m</span>Tc-FAPI uptake in a rare case of metastatic urachal carcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Captación de 99m Tc-FAPI en un caso raro de carcinoma de uraco metastásico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1041 "Ancho" => 2508 "Tamanyo" => 319303 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In the cystoscopy images, the red portion of the mass was identified as tumoral lesion (A, arrowhead). A biopsy was taken from this area, and the pathological sample revealed the presence of well-differentiated urachal adenocarcinoma of enteric type. This particular subtype bears a striking resemblance to primary colorectal carcinomas in terms of morphology (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pegah Sahafi, Salman Soltani, Kamran Aryana, Atena Aghaee" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Pegah" "apellidos" => "Sahafi" ] 1 => array:2 [ "nombre" => "Salman" "apellidos" => "Soltani" ] 2 => array:2 [ "nombre" => "Kamran" "apellidos" => "Aryana" ] 3 => array:2 [ "nombre" => "Atena" "apellidos" => "Aghaee" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000351?idApp=UINPBA00004N" "url" => "/22538089/0000004300000005/v1_202409120508/S2253808924000351/v1_202409120508/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2253808924000648" "issn" => "22538089" "doi" => "10.1016/j.remnie.2024.500031" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "500031" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2024;43:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Intrapancreatic splenic tissue simulating neuroendocrine tumor" "tienePdf" => "en" "tieneTextoCompleto" => "en" "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tejido esplénico intrapancreático simulando tumor neuroendocrino" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1572 "Ancho" => 2667 "Tamanyo" => 263544 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">PET and PET/CT images in axial, sagittal and coronal slices, respectively, showing the nodular image in the pancreatic tail, close to the spleen, with SUVmax 16.6 and 1.2 × 1.4 (TxAP) cm, suggestive of neuroendocrine tumor. FNA was obtained by echoendoscopy, with pathology result of negative for malignant cells in the referred material. Fragments of splenic tissue suggestive of intrapancreatic spleen. No representation of cellularity of neuroendocrine habitus is observed.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Rama Alonso, P. García-Talavera San Miguel, A.C. Peñaherrera Cepeda, E. Campaña Díaz, J.Á. Badell Martínez, F. Gómez-Caminero López" "autores" => array:6 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Rama Alonso" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "García-Talavera San Miguel" ] 2 => array:2 [ "nombre" => "A.C." "apellidos" => "Peñaherrera Cepeda" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Campaña Díaz" ] 4 => array:2 [ "nombre" => "J.Á." "apellidos" => "Badell Martínez" ] 5 => array:2 [ "nombre" => "F." "apellidos" => "Gómez-Caminero López" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X24000398" "doi" => "10.1016/j.remn.2024.500031" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X24000398?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000648?idApp=UINPBA00004N" "url" => "/22538089/0000004300000005/v1_202409120508/S2253808924000648/v1_202409120508/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Incomplete resection in a rare case of bladder paraganglioma revealed by diuretic <span class="elsevierStyleSup">123</span>I-MIBG SPECT/CT scan" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Amanda Padilla Bermejo, Javier Gatón Ramírez, Francisco José Pena Pardo, María de las Nieves Sicilia Pozo, María del Prado Talavera Rubio, Víctor Poblete García" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Amanda" "apellidos" => "Padilla Bermejo" "email" => array:1 [ 0 => "amanda.padilla.bermejo@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Gatón Ramírez" ] 2 => array:2 [ "nombre" => "Francisco José" "apellidos" => "Pena Pardo" ] 3 => array:2 [ "nombre" => "María de las Nieves" "apellidos" => "Sicilia Pozo" ] 4 => array:2 [ "nombre" => "María del Prado" "apellidos" => "Talavera Rubio" ] 5 => array:2 [ "nombre" => "Víctor" "apellidos" => "Poblete García" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Nuclear Medicine Department, Ciudad Real University General Hospital, Ciudad Real, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resección incompleta en un raro caso de paraganglioma vesical evidenciado mediante <span class="elsevierStyleSup">123</span>I-MIBG SPECT/TC con diurético" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2360 "Ancho" => 2508 "Tamanyo" => 421436 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">123</span>I-MIBG scintigraphy was performed after thyroid suppression with lugol (usual regimen) at 4 h and 24 h after administration of the radiopharmaceutical, acquiring full body planar images in anterior and posterior projections, and a SPECT/CT study at the pelvic level. Prior to the acquisition of the images, diuretic stimulation was performed by means of the iv injection of 40 mg of furosemide.<span class="elsevierStyleSup">123</span>I-MIBG in planar at 4 h (A), SPECT (B), CT (C) or fusion images (D) without evidence of lesions with avidity for the radiotracer.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 76-year-old man was being followed up for renal cysts. The last ultrasound revealed a 17 mm polypoid lesion on the anterior wall of the bladder. A cystoscopy confirmed a non-papillary nodular lesion, 1−2 cm in diameter. Transurethral resection was performed with a pathological diagnosis of non-functioning paraganglioma, according to analytical tests. After that, two months later, he underwent a <span class="elsevierStyleSup">123</span>I-MIBG scintigraphy after diuretic stimulation by means of intravenous furosemide, where tumor persistence was demonstrated (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">After confirming this by cystoscopy and once discussed in multidisciplinary committee, he was reoperated by partial cystectomy, with an anatomopathological result of infiltrating paraganglioma of the superficial muscular stratum, stage pT2aNxMx. A new <span class="elsevierStyleSup">123</span>I-MIBG scintigraphy (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), with diuretic stimulation, was carried out four months after reintervention, without evidence of lesions with avidity for <span class="elsevierStyleSup">123</span>I-MIBG.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Paraganglioma of the urinary bladder is a rare type of tumor that accounts for approximately 0.06% of bladder tumors, 1% of pheochromocytomas, and 10% of paragangliomas.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Is a neuroendocrine neoplasm, which arises from chromaffin cells located in the muscle layer of the bladder wall. Most of these tumors are solitary, arising on the dome or the trigone of bladder. Extra-adrenal paraganglioma has been associated with malignancy rates as high as 40%.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Based on the content and activity of catecholamine, extra-adrenal paraganglioma can be classified as functional (chromaffin) or non-functional (non-chromaffin) tumor. The clinical manifestations of paraganglioma of the urinary bladder include micturition syncope, hematuria, hypertension, headache, dizziness, sweating, and palpitations.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The diagnostic imaging modalities for bladder paraganglioma include ultrasound, computer tomography and magnetic resonance imaging. Thus, functional imaging methods provided by nuclear medicine, such as <span class="elsevierStyleSup">68</span>Ga-DOTATATE PET/TC and <span class="elsevierStyleSup">123</span>I-MIBG SPECT/CT, may be of great help.</p><p id="par0025" class="elsevierStylePara elsevierViewall">MIBG localizes in neurosecretory granules of catecholamine pathways, regardless of the functional state of the tumor, with sensitivity and specificity for the detection of paragangliomas of 56%–76% and 84%–100%, respectively.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> MIBG can therefore be very useful in the diagnosis of bladder paraganglioma as has been demonstrated in different reports.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The use of diuretic in PET/CT imaging has been well documented in literature for urinary bladder cancer with <span class="elsevierStyleSup">18</span>F-FDG. Nayak et al. concluded that diuretic <span class="elsevierStyleSup">18</span>F-FDG PET/CT plays an important role in improving detection of the primary tumor and locoregional staging of urinary bladder tumors. Diuretic <span class="elsevierStyleSup">18</span>F-FDG PET/CT demonstrated a higher diagnostic value when compared with contrast-enhanced computed tomography in these patients.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Due to the pooled activity in the urinary bladder makes the evaluation of bladder wall lesions difficult in the studies with <span class="elsevierStyleSup">18</span>F-FDG or <span class="elsevierStyleSup">123</span>I-MIBG by urinary elimination of the radiotracer, it was decided to perform diuretic stimulation. In our case, the diuretic assisted to correctly characterize bladder paraganglioma on SPECT/CT by improving the lesion-to-urinary background activity contrast.</p><span id="sec1005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1005">Funding</span><p id="par1035" class="elsevierStylePara elsevierViewall">This research has not received funding.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">No disclosure.</p><p id="par0040" class="elsevierStylePara elsevierViewall">All the authors confirm the fact that the article is not under consideration for publication elsewhere.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec1005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2480 "Ancho" => 2508 "Tamanyo" => 399794 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">123</span>I-MIBG scintigraphy was performed after thyroid suppression with lugol (usual regimen) at 4 h and 24 h after administration of the radiopharmaceutical, acquiring full body planar images in anterior and posterior projections, and a SPECT/CT study at the pelvic level. Prior to the acquisition of the images, diuretic stimulation was performed by means of the iv injection of 40 mg of furosemide.Anterior view of whole-body planar scan at 4 h (A) showed a focal deposit in midline of the bladder, corresponding to a nodular lesion of high uptake in SPECT/CT and higher density in CT than in the rest of the bladder. (B–D: SPECT, CT and fusion images, respectively) probably related to tumor remnants.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2360 "Ancho" => 2508 "Tamanyo" => 421436 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">123</span>I-MIBG scintigraphy was performed after thyroid suppression with lugol (usual regimen) at 4 h and 24 h after administration of the radiopharmaceutical, acquiring full body planar images in anterior and posterior projections, and a SPECT/CT study at the pelvic level. Prior to the acquisition of the images, diuretic stimulation was performed by means of the iv injection of 40 mg of furosemide.<span class="elsevierStyleSup">123</span>I-MIBG in planar at 4 h (A), SPECT (B), CT (C) or fusion images (D) without evidence of lesions with avidity for the radiotracer.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paraganglioma of the urinary bladder: a series of 22 cases in a single center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:8 [ 0 => "H. Zhai" 1 => "X. Ma" 2 => "W. Nie" 3 => "H. Li" 4 => "C. Peng" 5 => "X. Li" 6 => "Y. Zhang" 7 => "X. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clgc.2017.03.010" "Revista" => array:7 [ "tituloSerie" => "Clin Genitourin Cancer" "fecha" => "2017" "volumen" => "15" "numero" => "5" "paginaInicial" => "e765" "paginaFinal" => "e771" "itemHostRev" => array:3 [ "pii" => "S0016508515001006" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should every patient diagnosed with a phaeochromocytoma have a ¹²³ I-MIBG scintigraphy?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. van Berkel" 1 => "K. Pacak" 2 => "J.W. Lenders" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cen.12482" "Revista" => array:7 [ "tituloSerie" => "Clin Endocrinol (Oxf)" "fecha" => "2014" "volumen" => "81" "numero" => "3" "paginaInicial" => "329" "paginaFinal" => "333" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24796657" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diuretic 18F-FDG PET/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Nayak" 1 => "P.N. Dogra" 2 => "N. Naswa" 3 => "R. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-012-2294-6" "Revista" => array:7 [ "tituloSerie" => "Eur J Nucl Med Mol Imaging" "fecha" => "2013" "volumen" => "40" "numero" => "3" "paginaInicial" => "386" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23179944" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004300000005/v1_202409120508/S225380892400034X/v1_202409120508/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004300000005/v1_202409120508/S225380892400034X/v1_202409120508/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380892400034X?idApp=UINPBA00004N" ]
Journal Information
Interesting images
Incomplete resection in a rare case of bladder paraganglioma revealed by diuretic 123I-MIBG SPECT/CT scan
Resección incompleta en un raro caso de paraganglioma vesical evidenciado mediante 123I-MIBG SPECT/TC con diurético
Amanda Padilla Bermejo
, Javier Gatón Ramírez, Francisco José Pena Pardo, María de las Nieves Sicilia Pozo, María del Prado Talavera Rubio, Víctor Poblete García
Corresponding author
Nuclear Medicine Department, Ciudad Real University General Hospital, Ciudad Real, Spain