Superiority of F-18 FDG PET imaging for detection of a pheochromocytoma

Abstract: A 31-year-old pregnant patient presented at 13 weeks gestation with a discharging Bartholin's cyst and was found to be hypertensive and diabetic. The biochemical evaluation confirmed pheochromocytoma (PHEO) as a cause of her hypertension. Because PHEO is a potentially surgically curable cause of hypertension and may be fatal if left untreated, a quest for its definitive localization was undertaken. PHEO was not detected on either anatomic (MRI/CT) or functional (I-123 MIBG SPECT) imaging. Absence of cardiac uptake on I-123 MIBG supported the presence of PHEO. Coincidence PET using F-18 FDG detected the occult tumor. A paraaortic extraadrenal abdominal PHEO was resected, resulting in resolution of her hypertension.