Best way to localize extra-adrenal pheochromocytoma:-: (A) X-ray, (B) Nucleotide scan, (C) VMA excretion, (D) Clinical examination
Answer is B. IOC for extra adrenal pheochromocytoma is MRI>MIBG scan(aka-nucleotide scan) Imaging MRI is IOC for adrenal, extra adrenal pheochromocytoma and in pregnancy MRI is 95% sensitive and 100% specific for pheochromocytoma CT scan should be performed without contrast administration to avoid hypeensive crisis. MIBG scan is useful for extra-adrenal pheochromocytoma but IOC is MRI even for extra adrenal pheochromocytoma. Biopsy is contraindicated as it precipitates hypeensive crisis