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© The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com
Abstract:
A 14-year-old boy, who had undergone a left adrenalectomy for a
pheochromocytoma (PCC) four years earlier, suffered from a dull sensation in his
head and flushing of the face. He was referred to our hospital to evaluate a disease
recurrence.
With the use of PET/CT imaging, hypermetabolic lesions were observed in five
locations: three locations in the bilateral para-aortic region and two locations in the
left lower lung. After a thoracotomy, a pathology report confirmed that the lung
lesions were metastases from the PCCs.
To our knowledge, the application of PET/CT scanning in the restaging of
adolescent PCC is not frequently reported.1-3 In routine examinations, the detection of
PCCs is generally performed using CT or MRI first. If the results are unsatisfactory,
MIBG scintigraphy is typically performed next .4
PET/CT is an useful alternative
approach to CT, MRI, and MIBG scintigraphy and exhibits better resolution than
scintigraphic methods.4-5
We recommend that PET/CT imaging be performed first for adolescent PCC
patients to detect potential lung lesions. To reduce the level of radiation exposure that
occurs as a consequence of repeated CT examinations for suspicious small recurrent
foci, the recommended PET/CT imaging should be unenhanced and performed with
low radiation dosage at 20mAs, which is the lowest radiation threshold of our CT
scanner.
Keywords: pheochromocytoma, lung metastasis, adolescents, low radiation dose
PET/CT, 18F-FDG, restaging.
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