Pitfalls in diagnosing neuroblastoma: a case of unusual “adrenal tumor” accumulating [123I]I -MIBG

The "gold standard" for neuroblastoma (NB) imaging is [¹²³I]I-meta-iodobenzylguanidine ([¹²³I]I-MIBG) scintigraphy. This article presents a case of a child with an abdominal tumor that was suspected to be neuroblastoma. At the age of 2 months, a positive [¹²³I]I-MIBG scan initially supported the diagnosis. Active surveillance was initiated, and a follow-up [¹²³I]I-MIBG study at the age of 7 months revealed no radiotracer accumulation in the tumor. Despite the imaging findings, surgery was performed, and the tumor was found to be a subdiaphragmatic pulmonary sequestration. This case highlights the importance of correlating imaging findings with clinical and laboratory data to ensure an accurate diagnosis.