False-positive metaiodobenzylguanidine scan for neuroblastoma in a child with opsoclonus-myoclonus syndrome treated with adrenocorticotropic hormone (acth).
We describe the case of a 2-year-old girl with opsoclonus-myoclonus syndrome treated with chronic adrenocorticotropic hormone (ACTH) in which a metaiodobenzylguanidine scan showed abnormal radiotracer uptake in the left adrenal gland region, interpreted as the site of an occult neuroblastoma. As this finding was not corroborated by previous or subsequent metaiodobenzylguanidine scans or by computed tomography (CT) or magnetic resonance imaging (MRI), we attribute the finding to being a false-positive result from adrenal hyperplasia owing to chronic use of ACTH and not to neuroblastoma. Metaiodobenzylguanidine scintigraphy is an extremely important nuclear medicine examination tool used for the evaluation and staging of pediatric neuroblastoma. We highlight the need for cautious interpretation of metaiodobenzylguanidine as a screening tool for neuroblastoma in patients treated with ACTH.
McGarvey
Cynthia K
CK
Department of Neurology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202, USA.
Applegate
Kimberly
K
Lee
Nadine Deanie
ND
Sokol
Deborah K
DK
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D009447:Neuroblastoma / Q000000981:diagnostic imaging*; D053578:Opsoclonus-Myoclonus Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D006728:Hormones; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D000324:Adrenocorticotropic Hormone