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MIBG Case 3 Answers

1) Any evidence of a phaeochromocytoma?

There is strong uptake in the region of the left adrenal, in keeping with a phaeochromocytoma

2) Why is there very little cardiac activity?

In the presence of high levels of circulating adrenal hormones, cardiac adrenoceptors are downregulated. Uptake of MIBG is therefore reduced where phaeochromocytomas are highly active.

3) Name the syndrome

The history and young age of the patient would be typical for multiple endocrine neoplasia type 2. Specifically, the lack of mention of marfanoid habitus and mucosal neuromas suggest that this is type 2a or Sipple's syndrome.

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