PMC3976214_01
CT abdomen and pelvis: lytic lesion in the neck/greater trochanter of the left femur (white arrow).
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CT of the abdomen (Figure 1) and pelvis revealed a lytic lesion in the posterior aspect of the left pedicle and transverse process of L4, and the neck/greater trochanter of the left femur.
MIBG scan (before chemotherapy): widespread metastatic disease. F - front, B - back,
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Metaiodobenzylguanidine (MIBG) scan (Figure 2) revealed widespread metastatic disease.
MIBG scan (post-chemotherapy): interval progression of the metastatic disease (L - left, R - eight, A - anterior, P - posterior).
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Follow-up MIBG scan (Figure 3) 3 months after admission (3 cycles of chemotherapy) showed interval progression of the metastatic disease with recurrence in the right adrenal surgical bed, a new lesion in the left shoulder, progression to the left posterior 4th rib, and thoracolumbar and pelvic metastasis.