[Malignant XXXX . Apropos of a case with multiple metastatic localizations].

@entity1496 @entity712 @entity1911 @entity5 @entity935 @entity1854 @entity3 @entity299 @entity2661 @entity1718 @entity2401
We are reporting a case of @entity5 surgically treated initially for an isolated left pararenal localization, and which recurred several years later accompanied with numerous @entity3 . Despite of a treatment with @entity1496 131 MIBG, the evolution was rapidly fatal with a picture of @entity712 . This @entity299 would be linked to a @entity2401 directly secondary to the @entity2661 and causing a marked increase of the free @entity1718 concentration in the heart tissue. In reference to this case, all the data which may tend to suspect the malignant nature of a @entity1911 , present in 10 p. cent of the cases, are successively reviewed. There is no clinical specificity. The presence of a mixed secretion with marked urinary @entity935 secretion, would not present, for all authors, the same criteria of specificity. Thoraco-abdominal scan and scintigraphy with @entity1496 131 MIBG are the two tests permitting to demonstrate, with a great sensitivity and specificity, an extra-adrenal localization, which is the best argument in favor of a @entity5 since 30 to 40 p. cent of extra- @entity1911 are malignant, more especially as the @entity3 are located in areas where there are no embryonic remnants of tissues containing chromaffin cells. This permits to appreciate the difference between a non-malignant multicentric @entity1911 and a @entity5 . The ideal treatment of a @entity5 rests on surgery under the condition that there are ony one or two @entity3 . This procedure is preceded by a @entity1854 preparation and followed with an alpha-blockers treatment. In case of multiple @entity3 , the therapeutic use of @entity1496 131 MIBG seems to be a tempting alternative.
