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Ga-68 DOTATATE PET/CT in the Localisation of Succinate Dehydrogenase D Subunit (SDHD) Pheochromocytoma
Abstract
Pheochromocytoma and paraganglioma (PPGLs) are neural crest derived neoplasms. More than 35% of PPGLSs are hereditary with four common subunit gene mutations including succinate dehydrogenase (SDH) complex. This is a case report of 9-year-old girl with family history of SDHD gene mutation who presented with hypertensive urgency. She was treated with non-selective alpha blocker and was then arranged for ultrasound and MRI abdomen which both are suggestive of pheochromocytoma. She was referred to Nuclear Medicine Department for staging with Ga-68 DOTATATE PET/CT. The scan showed focal Ga-68 DOTATATE uptake seen at the left suprarenal mass and another focal uptake was seen at the hypodense lesion at right level II cervical region. This case report illustrates Ga-68 somatostatin agonist as the first choice of tracer for SDHx mutation as well as head and neck paraganglioma, extra- adrenal sympathetic multifocal and/or metastatic PPGLs.
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