{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:02:33Z","timestamp":1756425753647,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>An adult male in his early 30s diagnosed with multiple endocrine neoplasia type 2A syndrome, confirmed through genetic testing, presented as bilateral pheochromocytoma in a metachronous fashion, primary hyperparathyroidism and medullary thyroid carcinoma. Left and right adrenalectomy was done 9 years and 3 years ago, respectively. He was also subjected to total thyroidectomy with neck dissection and left inferior parathyroidectomy. During surveillance monitoring, 24-hour total urine metanephrines were elevated 13.977 mg (Normal value 0\u20131 mg) 1 year after right adrenalectomy. Adrenal CT scan demonstrated a 2.1 cm ovoid focus in the right suprarenal region, and functional imaging (<jats:sup>131<\/jats:sup>I meta-iodobenzylguanidine (MIBG scan) showed an avid uptake on the right frontal bone. Excision of the right adrenal bed and the right frontal bone tumour was performed, and metastatic pheochromocytoma was confirmed histologically. The patient achieved clinical and biochemical remission postoperatively and is currently receiving steroid and thyroxine replacement.<\/jats:p>","DOI":"10.1136\/bcr-2023-255302","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T13:00:12Z","timestamp":1706878812000},"page":"e255302","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare and aggressive metastatic pheochromocytoma recurrence in a patient with MEN 2A syndrome"],"prefix":"10.1136","volume":"17","author":[{"given":"Edrome Ferrer","family":"Hernandez","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Nemencio Almare","family":"Nicodemus","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"2025082723432674000_17.2.e255302.1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/66.2.279"},{"key":"2025082723432674000_17.2.e255302.2","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e318216cc6d"},{"key":"2025082723432674000_17.2.e255302.3","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/j.1365-2796.1995.tb01211.x","article-title":"Pheochromocytoma in multiple endocrine neoplasia type 2: European study","volume":"238","author":"Modigliani","year":"1995","journal-title":"J Intern Med"},{"key":"2025082723432674000_17.2.e255302.4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1653"},{"key":"2025082723432674000_17.2.e255302.5","doi-asserted-by":"crossref","unstructured":"Pal R , Rastogi A , Kumar S , et al . Metastatic pheochromocytoma in men 2A: a rare association. BMJ Case Rep 2018. doi:10.1136\/bcr-2017-222758","DOI":"10.1136\/bcr-2017-222758"},{"key":"2025082723432674000_17.2.e255302.6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11864-020-00787-z","article-title":"Emerging treatments for advanced\/metastatic pheochromocytoma and paraganglioma","volume":"21","author":"Ilanchezhian","year":"2020","journal-title":"Curr Treat Options in Oncol"},{"key":"2025082723432674000_17.2.e255302.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.07.016"},{"key":"2025082723432674000_17.2.e255302.8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1210\/endrev\/bnab019","article-title":"Personalized management of pheochromocytoma and paraganglioma","volume":"43","author":"N\u00f6lting","year":"2022","journal-title":"Endocr Rev"},{"key":"2025082723432674000_17.2.e255302.9","doi-asserted-by":"crossref","unstructured":"Feng B , Chen M , Jiang Y , et al . n.d. 18F-FDG PET\/CT in a patient with malignant pheochromocytoma recurrence and bone metastasis after operation-case report and review of the literature. 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