MedPix® Patient Chart - Case No: 2648 :: - Review Images

A 26-year-old white woman with an approximately 10-year history of hypertension that is poorly responsive to medical therapy. The patient has noted increasing headaches, sweating, and hot flashes over the past 6 months. She denies palpitations, dyspnea, fevers, nausea, vomiting, diarrhea or constipation.

Vital signs: BP: 130/90, HR: 90, RR: 20, T: 36.6.
No focal physical findings

24 hour urine collection:
   Norepi: 790 mcg
   Epi: <5.0 mcg
   Dopa: 302 mcg
   VMA: 17.1 mg
   Metanephrines: 4.0 mg

Glucagon and Clonidine tests positive.

- Review Images for PT: 2648

Small ovoid para-aortic mass with very intense signal on T2WI. It enhances on images not provided. The adrenals are normal.

It corresponds with a focus of MIBG uptake on nuclear medicine imaging.

- Review Images for PT: 2648

If no clinical information or MIBG imaging were available, the MR findings would still be fairly specific for a paraganglioma, but other possibilities for an enhancing retroperitoneal mass would still have to be considered, including adenopathy, fibromatosis, peripheral nerve sheath tumors, and sarcomas.

- Review Images for PT: 2648

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Treatment not available without Diagnosis

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