An ectopic pheochromocytoma on cardiac metaiodobenzylguanidine scintigraphy in a patient with Takotsubo cardiomyopathy

Introduction: Pheochromocytoma is one of the diseases that is known to cause Takotsubo cardiomyopathy, however, because of its rare occurrance a diagnosis of pheochromocytoma may be overlooked in patients with Takotsubo cardiomyopathy. Case Report: We report a case of a patient with Takotsubo cardiomyopathy which was discovered when the patient visited her doctor for consultation for a breast mass. During the visit she developed transient left ventricular dysfunction. Computed tomography scan detected a paraortic mass. After recovery, she underwent simultaneous operations for the breast cancer and the paraaortic mass and developed an acute hypertensive crisis. The paraaortic mass was diagnosed as ectopic pheochromocytoma. On retrospective examination, metaiodobenzyl­ guanidine scintigraphy, which was undertaken previously to assess suspected Takotsubo cardiomyopathy, showed an abnormal uptake in the paraaortic mass which was suspicious for pheochromocytoma. Conclusion: Pheochromo­cytoma can be detected as an incidental finding on metaiodobenzylguanidine cardiac scintigraphy, which is used to evaluate patients with Takotsubo cardiomyopathy or heart failure.