ROLES OF NUCLEAR MEDICINE IMAGINGS IN DIAGNOSIS MULTIPLE ENDOCRINE NEOPLASIA TYPE 2a: A CASE REPORT
Keywords:
multiple endocrine neoplasia, MEN 2a, nuclear medicine imaging, 131I -MIBGAbstract
Multiple endocrine neoplasia type 2a (MEN 2a) 1s rare, with complex disorders. MEN 2a is characterized by medullary thyroid carcinoma in combination with pheochromocytoma and hyperparathyroidism. We report a case of 48-year-old woman who had a severe hypertension. Physical examination revealed a painless enlarged thyroid gland and palpable abdominal mass. Hyperparathyroidism was diagnosed by elevated serum calcium level and parathyroid hormone level. 99mTc-pertechnetate thyroid scinitigraphy showed 2 hypofunctioning nodules at both thyroid lobes but both nodules were hot on 131I MIBG imaging. 131I MIBG imaging also revealed intense uptake at both enlarged adrenal glands. Medullary thyroid carcinoma and pheochromocytomas were subsequently proved by pathologic sections. Double phase 99mTc sestamibi parathyroid scintigraphy showed intense uptake at the right side of lower neck, suggesting parathyroid adenoma or hyperplasia. In conclusion,nuclear medicine JAN. - APR. 2002. Volume VIII NumberI imaging is very useful in the diagnosis of MEN 2a.
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