Scintigraphic portrayal of the syndrome of multiple endocrine neoplasia type-2B

Clinical Nuclear Medicine
J J YobbagyT Polley

Abstract

The scintigraphic appearance of the neoplasms in multiple endocrine neoplasia type 2B (MEN-2B) and the interpretations of the image patterns are described. An 18-year-old male patient with the MEN-2B syndrome underwent TI-201 imaging that showed concentrations of TI-201 in the primary medullary thyroid carcinoma (MTC) tumor and in cervical lymph node metastases. After total thyroidectomy and lymph node dissection, the TI-201 image was normal. Catecholamine levels in the blood and urine were only borderline elevated. Yet, greater than normal concentrations of I-131 metaiodobenzylguanidine (I-131 MIBG) were present in both adrenal glands. Computed tomography of the abdomen showed normal adrenal glands. These results were consistent with the diagnosis of adrenal medullary hyperplasia, a precursor of pheochromocytoma. No operation was indicated to remove the adrenal glands. Imaging with TI-201 appears to be useful in identifying sites of MTC in patients with the MEN-2B syndrome. I-131 MIBG imaging, in conjunction with computed tomography of the adrenal glands and appropriate catecholamine measurements, should be performed in patients with the MEN-2B syndrome to determine the status of the adrenal medullae, which then may be classif...Continue Reading

Citations

Sep 1, 1996·Clinical Nuclear Medicine·J T NielsenM Rehling
Jan 27, 1998·Clinical Nuclear Medicine·Y YamamotoM Tanabe
Jun 1, 1991·Pediatric Dermatology·J F KirkJ F Browder
Apr 1, 1997·Thyroid : Official Journal of the American Thyroid Association·J C Sisson
Nov 1, 1989·Journal of Endocrinological Investigation·M Mannelli

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