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6 years [7]. Although malignant pheochromocytoma is not pathognomic, in CT it is seen GDC-0449 supplier as a heterogeneous mass of irregular shape, with an average size of 5?cm and accompanying necrosis [19]. In the present patient, malignancy was first suspected from CT findings and considering the size of the tumor. The patient underwent surgical resection for definitive diagnosis and correction of excess hormonal secretion. Unfortunately, two days after surgery, the patient developed pulmonary thromboembolism, pulmonary infarction, and pneumonia, which did not improve. The patient died 2 months after his initial diagnosis. The utility of 123I-MIBG scintigraphy in diagnosis of pheochromocytoma is widely known and can be performed in cases where catecholamine excess is not confirmed by biochemical testing, but when clinically suspected. However, despite the fact that 123I-MIBG scintigraphy is an outstanding functional imaging tool, due to the remote possibility of false positive uptake, interpretation of 123I-MIBG scintigraphy and diagnosis of pheochromocytoma should be made with caution. When the degree of 123I-MIBG uptake is low-grade in relationship to a large tumor mass, then a false positive result should be entertained, particularly in the absence of typical clinical and biochemical features of pheochromocytoma. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this MS-275 research buy Quinapyramine paper.Colorectal cancer is the third most common type of cancer globally, and most frequently it spreads to the regional lymph nodes, liver, lungs, and bone, in descending order [1]. It is very rare to find metastasis of colonic adenocarcinoma to the breast and, thus, they often may be confused with primary neoplasms of the breast [2]. The median age at which these metastases occur is 54 years and the prognosis is poor because they indicate an advanced or disseminated disease [1, 3]. The first described case of colon cancer metastasizing to the breast was reported in 1974 by McIntosh and, since that time, there are only a few reported cases in the literature [4]. Obtaining a detailed past medical history, appropriate radiologic work-up, followed by a tissue biopsy with histologic and immunohistochemical work-up, has proven to be extremely helpful in determining the source of the malignancy. Anti-cytokeratin 7 (CK 7) and anti-cytokeratin 20 (CK 20) antibodies have been used to differentiate between cancers of a primary or metastatic source [2]. CK 7 (?)/CK 20 (+) represents a colonic adenocarcinoma staining pattern, whereas CK 7 (+)/CK 20 (?) represents a breast carcinoma staining pattern [2]. The use of additional breast tumor markers, such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2/neu), can be used for confirmation of the source of the tumor [2].
