MIBG Case 2 Answers

1) Any evidence of a phaeochromocytoma?

There is increased uptake in the region of the left adrenal, suggesting a phaeochromocytoma in this region. It is a little faint as 80% of phaeochromocytomas have more uptake than liver.

2) What are the CT findings of a phaeo?
3) Should IV contrast be used?

Phaeochromocytomas are usually >3cm, of soft tissue density and may have a necrotic centre. 10% are cystic and calcification is occasionally seen. Generally speaking, contrast should be avoided as it may precipitate a hypertensive crisis. To that end, angiography is relatively contraindicated.

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