A Phaeochromocytoma of the Organ of Zuckerkandl
Phaeochromocytomas are paragangliomas composed of chromaffin cells, which arise from the adrenal medulla and produce excess amounts of catecholamines.
Malignant pheochromocytomas are rare, about 3/10,000,000 incidents a year.
A 26-year-old male presented to the Emergency Department following a motorbike accident. A CT was performed 2 weeks after the accident and identified a mass in the Organ of Zuckerkandl. Blood tests concluded that the mass was a phaeochromocytoma which was then surgically removed. Both I-123 MIBG and In-111 OctreoScan have been used to monitor this patient's progress over the last 2 years. Planar and SPECT imaging was utilized during Bone, PET, MIBG and OctreoScan studies which aided in definitively locating the metastatic spread. I-131 MIBG therapy was dictated as the best treatment option to eradicate or relieve the symptoms of metastatic spread of a phaeochromocytoma. The advantages of tissue localisation and decreased radiation burden to other soft tissue make this the optimal method of treatment.
This case presentation highlights the value of Nuclear Medicine in the diagnosis, prognosis and treatment of a patient with a malignant phaeochromocytoma.