Fig. 4

A 20 year old male with SDHB germline mutation and metastatic PCC. Baseline Ga-68 DOTATATE (a) and F-18 FDG (b) demonstrated metastatic disease with a concordant pattern of uptake. The patient was treated with 3 cycles of peptide receptor radionuclide therapy for uncontrolled hypertension. Follow-up DOTATATE and FDG imaging over a 2 year period demonstrated stable findings (c: FDG at 2 years). The high FDG-uptake was not predictive of an aggressive phenotype and reflects changes secondary to SDHB mutation and consequent disordered oxidative phosphorylation