Based at Orange County California’s  Fullerton Municipal Airport - KFUL

He primary neoplasm with intra-adrenal tumors having a <10% chance of metastasis. [10] however, in patients like ours who have a history of extra-adrenal abdominal paraganglioma, reported rates of malignancy have varied between 15% and 35%. cheap generic viagra [7],[10],[14] currently, no microscopic or laboratory criteria exist to reliably predict metastatic potential. However, malignant tumor is more often associated with a greater dry weight of the primary tumor, confluent necrosis, and presence of local invasion. compare viagra viagra dosage [3],[7] the assessment for metastatic disease is performed via various imaging techniques. viagra effect women Besides standard mri and ct imaging, functional nuclear medicine tests have increasingly been used to assess the extent of disease of neuroendocrine tumors. much does viagra cost cvs The most common nuclear medicine test for pheochromocytoma/paraganglioma is the mibg scan. [2] radio-labeled mibg is a molecular analog of norepinephrine that has gained popularity due to its highly specific uptake into the tissue of neural crest origin by plasma membrane norepinephrine transporters. viagra for sale [11] a recent prospective multicenter trial performed by wiseman et al. viagra effect women Estimated the sensitivity and specificity of this test at 82-88% and 82-84%, respectively. [11] while mibg scanning remains the mainstay, other functional studies such as octreotide scanning are being actively investigated and compared to mibg results. generic viagra canada Radio-labeled octreotide is an analog of the naturally occurring hormone somatostatin that has been found to be useful in imaging neuroendocrine tumors due to its specific binding to somatostatin receptors on tumor cells of this subgroup. viagra for sale in ireland [6] interestingly, octreotide scanning may be superior to mibg scanning depending on the location of the tumor, with one study by koopmans et al. Suggesting that octreotide scanning may be superior to mibg scanning for the detection of primary head and neck paragangliomas. [6] defining the extent of disease is important as surgical resection is the mainstay of treatment even for metastatic disease. viagra canada If the disease is not resectable, chemotherapy and/or application of therapeutic levels of i-131 mibg for radiotherapy may be considered. [9] given the small numbers of patients with metastatic paragan. buy viagra cheap