Reporting a Case of False-positive Radio-iodinated Metaiodobenzylguanidine (123I-MIBG) Uptake in Undifferentiated Adrenal Malignant Tumor

Reporting a Case of False-positive Radio-iodinated Metaiodobenzylguanidine (123I-MIBG) Uptake in Undifferentiated Adrenal Malignant Tumor

123-Metaiodobenzylguanidine (MIBG) scintigraphy is a commonly used functional imaging technique for diagnosing pheochromocytoma with a high degree of sensitivity and specificity. However, there have been a few reports of false positive reactions. A 67-year-old man was admitted to the hospital with epigastric pain. Following hormone monitoring, 123I-MIBG scintigraphy was performed to assess the existence of pheochromocytoma, which indicated eccentric uptake by a large left adrenal gland mass on abdominal computed tomography (CT). Metastatic lymphadenopathy was confirmed by chest CT and PET-CT. Endobronchial ultrasound transbronchial needle aspiration was used as a result. A lymph node biopsy revealed metastatic carcinoma of unknown origin, and surgical resection was performed to confirm the diagnosis and correct the excess hormonal secretion. Despite the uptake of MIBG shown by scintigraphy, a final diagnosis of undifferentiated adrenal malignant tumour was made, rather than histologically malignant pheochromocytoma. In the absence of traditional clinical and biochemical features of pheochromocytoma, a false-positive result should be considered when the degree of MIBG uptake is poor in relation to a large tumour mass.

Author (s) Details

Hee Soo Jung
Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Seok Jun Moon
Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Yun Mi Kim
Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Hye Rim Kang
Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Seok Mo Lee
Department of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.

Soo Jin Jung
Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.

Seok Jin Choi
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.

Tae Kyoon Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Min Jeong Kwon
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Jeong Hyun Park
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

Soon Hee Lee
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.

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