Primary diagnosis of multiple pheochromocytomas in the brother of a MEN-2 patient by simultaneous MIBG scintigraphy and low-dose computed tomography

Metaiodobenzylguanidine (MIBG) scintigraphy is a well-established functional imaging method for localizing pheochromocytomas. However, the morphologic information revealed on the scintigram is often too sparse and thus, accordingly, supplemental computed tomography (CT) or magnetic resonance imaging are often performed. Recently, gamma cameras with built-in low-dose CT were introduced. The authors describe a patient with a high likelihood of pheochromocytoma who had simultaneous MIBG scintigraphy and low-dose CT performed as the primary examinations. The scan revealed pheochromocytomas in both adrenal glands and one extra-adrenal pheochromocytoma located in the liver. The combined imaging ensured the final diagnosis without any need for further imaging. Based on the findings of this case, the authors believe that combined MIBG scintigraphy and low-dose CT is a promising future single imaging technique for pheochromocytomas.