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CC BY-NC-ND 4.0 · World J Nucl Med 2017; 16(02): 169-171
DOI: 10.4103/1450-1147.203074
Case report

Incidental detection of synchronous medullary thyroid carcinoma with bilateral adrenal pheochromocytoma on iodine-123 metaiodobenzylguanidine scintigraphy, leading to diagnosis of multiple endocrine neoplasia 2A

Asif Fakhri
Department of Nuclear Medicine and Molecular Imaging, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
,
Paul Rodrigue
Department of Nuclear Medicine and Molecular Imaging, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
,
Mustafa Aladin
1   Department of Internal Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
,
Aun Hussain
Department of Nuclear Medicine and Molecular Imaging, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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We report a case of a 29-year-old female with the family history of medullary thyroid carcinoma (MTC) presenting with hematuria and tachycardia, who was found to have bilateral adrenal masses on abdominal computed tomography and biochemical testing compatible with pheochromocytoma. Iodine-123 (I-123) metaiodobenzylguanidine (MIBG) scintigraphy for preoperative planning prior to planned adrenalectomy revealed incidental synchronous unifocal MTC, along with expected bilateral adrenal pheochromocytomas. Pathology confirmed these findings, and subsequent genetic testing confirmed a rearranged during transfection proto-oncogene mutation on exon 11, confirming the clinical diagnosis of multiple endocrine neoplasia 2A (MEN 2A). The unexpected incidental finding of synchronous MTC highlights the importance of considering MEN in the differential diagnosis when encountered with newly diagnosed pheochromocytoma and highlights the utility of I-123 MIBG scintigraphy in diagnostic workup of newly diagnosed pheochromocytoma.

Keywords

Iodine-123 metaiodobenzylguanidine - medullary thyroid carcinoma - multiple endocrine neoplasia - pheochromocytoma - rearranged during transfection


Publication History

Article published online:
18 May 2022

© 2017. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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