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CASE REPORT
Year : 2017  |  Volume : 16  |  Issue : 2  |  Page : 169-171

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


1 Department of Nuclear Medicine and Molecular Imaging, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
2 Department of Internal Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA

Correspondence Address:
Asif Ali Fakhri
Department of Nuclear Medicine and Molecular Imaging, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, 105 Parker Hall, 3435 Main Street, Buffalo, New York 14214-3007
USA
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DOI: 10.4103/1450-1147.203074

PMID: 28553188

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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.


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