Tc-99m MIBG Imaging in a Huge Clinically Silent Pheochromocytoma with Cystic Degeneration and Massive Hemorrhage

Abstract

I-131 metaiodobenzylguanidine scintigraphy showed marked accumulation in the walls of a clinically silent, huge cystic adrenal mass with a prominent hemorrhage in a 48-year-old man. Although a careful reexamination of the histologic specimen finally lead to a diagnosis of pheochromocytoma, the appearances of this mass on computed tomography and magnetic resonance imaging were not specific for this neoplasm, and even pathologic analysis initially indicated, incorrectly, that this lesion was a hemorrhagic hemangioma. This case shows that I-131 metaiodobenzylguanidine scintigraphy is useful for correctly diagnosing an adrenal mass with prominent cystic or hemorrhagic degeneration.

Giant multicystic malignant pheochromocytoma

“…The average tumor size is approximately 7 cm (2). There are only few reports of huge multicystic malignant pheochromocytoma above 18 cm, and to our knowledge, the pheochromocytoma in this case is the largest one reported from our country (1,(3)(4)(5)(6)(7)(8). Seven giant pheochromocytomas larger than 16 cm in current literature have been documented (Table 1).…”

“…The average tumor size is approximately 7 cm, and the average weight is approximately 200 g in the previous publications (2). Sometimes these tumors may be bigger (1,(3)(4)(5)(6)(7)(8). In this report, a case of multicystic malignant pheochromocytoma with a huge size is presented, which is seldom reported in the past.…”

Giant cystic pheochromocytoma: A silent entity

“…There are 20 case reports of pheochromocytomas more than 10 cm in the worldwide literature. [ 7 8 9 ] On extensive search of indexed literature, it turned out to be the first largest cystic pheochromocytoma from India and third largest such tumor in the world.…”

Largest pheochromocytoma reported in Canada: A case study and literature review

“…Nineteen giant PCCs larger than 10 cm have been documented (Table 2). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In this group of studies, the mean age was 48 years (range: 12-81), with 58% being male. Eight cases presented asymptomatically at the time of diagnosis, 4 had hypertension, and 1 other in addition to this case presented with dyspnea accompanied with chest pain, paraesthesia, and palpitations.…”