[Nuclear medicine diagnosis and treatment in pheochromocytoma and neuroblastoma]

Localization procedures are required in catecholamine producing tumors following clinical and biochemical confirmation of phaeochromocytoma or neuroblastoma. Whereas computed tomography and ultrasound reflect morphological abnormalities, adrenomedullary scintigraphy with radiolabeled meta-iodobenzylguanidine depends on function. MIBG scintigraphy has the advantage of being able to detect intra- and extra-adrenal, uni- and bilateral or multilocular, benign and malignant phaeochromocytomas and neuroblastomas. Especially small lesions and tumor tissue in bone marrow in children with neuroblastoma can be visualized more easily. The same radiopharmaceutical agent radiolabeled with high doses of 131I may be used for treatment of phaeochromocytomas and neuroblastomas stage III and IV. In patients with malignant phaeochromocytomas this therapy may improve clinical symptoms and reduce tumor volume for months or even years, but probably this therapy is not curative. In children with neuroblastoma complete remission may be achieved by combining surgery, chemotherapy, and 131I-MIBG treatment. Therefore, this therapeutic modality should be included in the therapeutic strategy of stage III and IV neuroblastoma.