Multiple Pheochromocytomas in a Patient With Blurred Vision

We report on a 19-year-old male diagnosed with multiple pheochromocytomas after an I-123 metaiodobenzylguanidine (MIBG) scan. Multiple imaging was obtained because of concern for von Hippel-Lindau disease (VHL) after bilateral retinal angiomas were discovered on ophthalmologic consultation as a foll...

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Bibliographic Details
Published in:Clinical nuclear medicine 2008-09, Vol.33 (9), p.597-601
Main Authors: Thoren, Kendra L, Balingit, Antonio G, Billingsley, Jerome
Format: Article
Language:English
Subjects:
3-Iodobenzylguanidine
Adult
Brain - diagnostic imaging
Humans
Magnetic Resonance Imaging
Male
Pheochromocytoma - complications
Pheochromocytoma - diagnosis
Pheochromocytoma - diagnostic imaging
Pheochromocytoma - surgery
Spine - diagnostic imaging
Tomography, X-Ray Computed
Vision Disorders - complications
Vision Disorders - diagnosis
Vision Disorders - diagnostic imaging
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Summary:We report on a 19-year-old male diagnosed with multiple pheochromocytomas after an I-123 metaiodobenzylguanidine (MIBG) scan. Multiple imaging was obtained because of concern for von Hippel-Lindau disease (VHL) after bilateral retinal angiomas were discovered on ophthalmologic consultation as a follow-up from the Emergency Department. Computed tomography (CT) and magnetic resonance imaging (MRI) were able to localize the adrenal and extra-adrenal tumors; however, accurate differentiation between pheochromocytomas and other adrenal tumors was not possible. I-123 MIBG is the test of choice for evaluating functionality and location of pheochromocytomas because of its high sensitivity and specificity. I-123 MIBG was performed before surgery to confirm that the lesions were indeed pheochromocytomas and also to rule out metastatic disease. He was started on α- and β-blocker medication for at least 3 weeks, followed by surgery. The postoperative period was uneventful. DNA testing was performed and revealed mutations in the VHL gene previously reported to be associated with von Hippel-Lindau syndrome type II and genetic counseling was recommended. He was presented in urology tumor board conference with recommendations for follow-up CT and laboratory tests after 3 months. Otherwise, the patient is doing well and asymptomatic at this time.
ISSN:0363-9762
1536-0229
DOI:10.1097/RLU.0b013e3181813096