02-17-2017, 09:46 AM
A 23-year-old man known to have neurofibromatosis, type 1 (von Recklinghausen's disease),
presents with a left lower quadrant abdominal mass and signs of neurologic deficits in his left leg. In the ensuing workup, it is determined that he has higher than normal values of catabolites of pinephrine and norepinephrine in a 24-hour urinary collection. He is currently normotensive. Before invasive steps are taken to biopsy and eventually remove his left lower quadrant abdominal mass, which of the following is the most appropriate next step in management?
A. CT scan of the head looking for meningiomas
B. MRI of his adrenal glands
C. MRI of the acoustic nerves
D. Radionuclide scans from the neck to the pelvis looking for extra-adrenal pheochromocytomas
E. Radiation therapy to the left lower quadrant abdominal mass
presents with a left lower quadrant abdominal mass and signs of neurologic deficits in his left leg. In the ensuing workup, it is determined that he has higher than normal values of catabolites of pinephrine and norepinephrine in a 24-hour urinary collection. He is currently normotensive. Before invasive steps are taken to biopsy and eventually remove his left lower quadrant abdominal mass, which of the following is the most appropriate next step in management?
A. CT scan of the head looking for meningiomas
B. MRI of his adrenal glands
C. MRI of the acoustic nerves
D. Radionuclide scans from the neck to the pelvis looking for extra-adrenal pheochromocytomas
E. Radiation therapy to the left lower quadrant abdominal mass