Document Detail

Bilateral Pheochromocytoma importance of multimodality imaging assessment.
MedLine Citation:
PMID:  24862676     Owner:  NLM     Status:  Publisher    
INTRODUCTION: bilateral pheochromocytomas ( PHEO ) are rare, often hereditary and linked to a germline mutation of RET, VHL or SDHx. However they also occur sporadically.
PRESENTATION OF CASE: we report a case of a 76 year old female hospitalized for biological investigations following symptoms of abdominal discomfort with recurrent hypertensive episodes. The hormonal work up results favoured a diagnosis of a PHEO (urinary and plasma metanephrines > 10 times normal). Radiological investigations (CT-MRI): identified bilateral adrenal masses (47 mm in the right adrenal, 26 mm in the left adrenal). Functional imaging with I 123 MIBG scintigraphy showed intense uptake in the right adrenal mass with limited uptake in the left, probably related to a fixation of the normal adrenal medulla. Due to the strong suspicion of bilateral PHEO, further imaging with an 18F-FDOPA PET was performed. This revealed intense hypermetabolism of the right mass but the left mass had similar metabolism to the liver, thought to be unsuspicious for a PHEO. It was decided to proceed with a laparoscopic right adrenalectomy. Hormonal investigations performed post-operatively revealed persistently elevated metanephrines and an 18F-FDG PET was performed, revealing an intense hypermetabolic focus in the left adrenal gland. A laparoscopic partial left adrenalectomy was subsequently performed 6 weeks after the initial right adrenalectomy.
DISCUSSION AND CONCLUSIONS: this case highlights the possibility of false negative results using specific functional imaging. In these situations, 18F-FDG PET may be useful. The MRI signal has an indisputable value. Until today, no germline mutation was found in this patient on RET, SDHx or VHL genes.
Nunzia Cinzia Paladino; Aoife Lowery; Carole Guerin; David Taieb; Frédéric Sebag
Related Documents :
7769636 - Noncalcified pulmonary tuberculomas: ct enhancement patterns with histological correlat...
24605256 - Adrenal lesions: spectrum of imaging findings with emphasis on multi-detector computed ...
19198846 - Macrophage imaging by uspio-enhanced mr for the differentiation of infectious osteomyel...
650246 - Diagnosis of subdural haematoma by computed axial tomography: use of xenon inhalation f...
24848086 - Protocol for a prospective neuroimaging study investigating the supraspinal control of ...
7553026 - Mr imaging of musculoskeletal tumors of the hand and wrist.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-23
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  -     ISSN:  1743-9159     ISO Abbreviation:  Int J Surg     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Ltd.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Clinicopathological pattern of lymph node recurrence of papillary thyroid cancer. Implications for s...
Next Document:  Resection of carotid body tumors reduces arterial blood pressure. An underestimated neuroendocrine s...