Use of 99mTc-Sestamibi SPECT/CT in the Diagnosis of Hybrid Oncocytic/Chromophobe Tumor in a Pediatric Patient

The differential diagnosis of solid renal neoplasms in adolescence includes aggressive malignancy and indolent oncocytic tumors which are typically indistinguishable using conventional imaging. We report use of 99mTc-sestamibi single photon emission computed tomography/x-ray computed tomography (SPECT/CT) in characterizing enhancing renal neoplasms in a pediatric patient. Genetic testing suggested a hereditary syndrome associated with aggressive malignancy, while renal mass biopsy suggested an oncocytic tumor. 99mTc-sestamibi SPECT/CT indicated probable oncocytomas or hybrid oncocytic/chomophobe tumors (HOCT). Enucleative resection was performed with final pathology demonstrating HOCTs. This case highlights the potential utility of 99mTc-sestamibi SPECT/CT in characterizing indeterminate enhancing renal neoplasm in pediatric patients.

Urology. 2017 Nov 23 [Epub ahead of print]

Nima Almassi, Michael A Gorin, Andrei Purysko, Steven P Rowe, Jihad Kaouk, Mohamad E Allaf, Steven C Campbell, Audrey Rhee

Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH, USA., The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA., Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: .

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