Case of the Month 2015-11

Submitted by Charles Rawson, MD, Skorn Ponrartana, MD, PhD (Children's Hospital Los Angeles), and Thomas J. Learch, MD.

History

  • 17 year old female presents with intermittent headache, fatigue, weakness, and night sweats. Symptoms have been progressively worsening. She also complains of dizziness, abdominal pain, nausea, hair loss, and throat tightness.
  • Cardiac Holter monitor demonstrated sinus tachycardia. Thyroid hormone and TSH levels are normal. Plasma normetanephrine is 1261 pg/mL.

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Question

An MRI abdomen pelvis was obtained. What is the most likely diagnosis?
A) Pheochromocytoma
B) Neuroblastoma
C) Paraganglioma
D) Lymphoma
E) Tuberculosis

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