A case of malignant pheochromocytoma treated with 131I-metaiodobenzylguanidine and alpha-methyl-p-tyrosine.
A 47-year-old man had surgery for paraaortic paraganglioma in 1980 and 1985. In 1987, his urinary excretion of catecholamines and metabolites was extremely high. Scintigraphy with 131I-metaiodobenzylguanidine (MIBG) showed multiple bone and liver metastases. He was treated twice with infusions of 3.7 GBq of 131I-MIBG. After the first treatment, he had transient hypertension and pain in the back and right leg. Subsequent 131I-MIBG scintigraphy showed that the number of metastatic tumors had decreased. The second treatment was less effective. Excess catecholamines were treated with alpha-methyl-p-tyrosine (MPT), a catecholamine synthesis inhibitor, at doses between 250 and 2000 mg/day, which significantly decreased urinary NE excretion. This is the first case treated with 131I-MIBG in Japan.
Nakagami
Y
Y
Department of Medicine, Tokyo Women's Medical College, Japan.
Nomura
K
K
Kusakabe
K
K
Miko
N
N
Tsushima
T
T
Demura
H
H
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001774:Blood Chemical Analysis; D004837:Epinephrine / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D007462:Iodobenzenes / Q000627:therapeutic use*; D008297:Male; D008676:Metanephrine / Q000378:metabolism; D008781:Methyltyrosines / Q000627:therapeutic use*; D008875:Middle Aged; D009638:Norepinephrine / Q000378:metabolism; D009647:Normetanephrine / Q000378:metabolism; D010673:Pheochromocytoma / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D011877:Radionuclide Imaging; D014446:Tyrosine 3-Monooxygenase / Q000008:administration & dosage; D014642:Vanilmandelic Acid / Q000378:metabolism; D019805:alpha-Methyltyrosine
D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008781:Methyltyrosines; D009647:Normetanephrine; D019797:3-Iodobenzylguanidine; D008676:Metanephrine; D014642:Vanilmandelic Acid; D019805:alpha-Methyltyrosine; D014446:Tyrosine 3-Monooxygenase; D009638:Norepinephrine; D004837:Epinephrine