This case highlights a rare presentation of primary intraosseous paraganglioma in the appendicular skeleton, emphasizing the need for multimodal diagnostics and multidisciplinary care.
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Conservative management feasible for rare femoral neck paraganglioma in frail elderly; leaves open need for prospective data on outcomes.
CASE: An 88-year-old woman presented with worsening right hip pain over 2 years. Radiographs were unremarkable, but magnetic resonance imaging identified a femoral neck lesion. A computed tomography-guided biopsy revealed a zellballen pattern of cells positive for chromogranin and synaptophysin. Further workup, including a metaiodobenzylguanidine scan confirmed focal uptake at the right femoral neck. After multidisciplinary discussion, and shared decision-making with the patient, conservative management was chosen. CONCLUSION: Primary intraosseous paragangliomas are rare, with this case representing only the second reported in femur and third in the appendicular skeleton. It underscores the importance of a multimodal diagnostic approach, individualized treatment plans, and multidisciplinary collaboration.
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González-Díaz et al. (2025) studied this question.
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