Primary Extra-Adrenal Pheochromocytoma Positive I-123 MIBG Imaging with Negative I-131 MIBG Imaging

I-131 metaiodobenzylguanidine (I-131 MIBG) is a well established imaging agent that reliably detects pheochromocytoma. In some patients, however, I-131 MIBG may fail to localize pheochromocytoma. I-123 MIBG has several potential advantages over I-131 MIBG, and these advantages may enable locating pheochromocytomas which have eluded other techniques, including I-131 MIBG imaging. A patient with primary extraadrenal pheochromocytoma is described who illustrates the superiority of I-123 MIBG for the imaging of pheochromocytoma.