25 y/o female, with severe hypertension and chronic renal failure. Underwent a 131 I  MIBG scan to rule out pheochromocytoma. Metanephrines levels were normal and MRI showed a suprarenal mass suggestive of pheochromocytoma. Irregular area without I131 MIBG uptake in the right adrenal at 48 h (black arrow) and 72 hrs. Concomitant DMSA scan to localize accurately the area of the adrenals. (red arrow). The fusion image with MIBG SPECT/ MRI confirms that there is no uptake in the mass. Biopsy was compatible with hemangiopericytoma, a rare mesenchymal tumour, that is believed to originate from the pericyte of Zimmermann. and may affect every organ in the body  (1).  MIBG scintigraphy has sensitivity and specificity greater han 90% for detection of neuroblastoma and pheochromocytoma (2).

References:

1.- Cancer Imaging. 2009 Jun 15;9:32-4.

2.- J Clin Endocrinol Metab 95: 2596–2606, 2010.

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