Focal False-Positive 18F-MFBG Uptake in the Kidney Attributable to Renal Infarction in a Pediatric Patient With Pheochromocytoma

A 10-year-old boy was enrolled in our clinical trial. He underwent 18 F-MFBG PET/CT imaging for the differential diagnosis of a right adrenal lesion, which revealed moderate 18 F-MFBG uptake in the lesion with a central photopenic defect. Concurrently, focal increased 18 F-MFBG uptake was observed in the lower pole of the right kidney. Retrospective review of prior abdominal contrast-enhanced CT demonstrated imaging features consistent with renal infarction. Surgical pathology confirmed a right adrenal pheochromocytoma. This case illustrates that focal renal 18 F-MFBG uptake may arise secondary to renal infarction, which should be considered in the differential diagnosis of atypical 18 F-MFBG accumulation.