PET scanning: A promising technique for detection and localization of pheochromocytomas
Abdominal CT scanning: Has accuracy of 85-95% for detecting adrenal masses with a spatial resolution of 1 cm or greater
Genetic testing for mutations causing the MEN 2A and 2B syndromes
Scintigraphy: Reserved for biochemically confirmed cases in which CT scanning or MRI does not show a tumor
MRI: Preferred over CT scanning in children and pregnant or lactating women; has reported sensitivity of up to 100% in detecting adrenal pheochromocytomas
Consultation with an ophthalmologist to rule out retinal angiomas (VHL disease)
Serum intact parathyroid hormone level and a simultaneous serum calcium level to rule out primary hyperparathyroidism (which occurs in MEN 2A)
Use 24-hour urinary collection for catecholamines and metanephrines in patients at lower risk
Plasma metanephrine testing: 96% sensitivity, 85% specificity
24-hour urinary collection for catecholamines and metanephrines: 87.5% sensitivity, 99.7% specificity
Use plasma metanephrine testing in patients at high risk (ie, those with predisposing genetic syndromes or a family or personal history of pheochromocytoma)
Screening for mutations in the ret proto-oncogene (which give rise to MEN 2A and 2B)
