Radioactive MIBG can be used in radioguided surgery for neuroendocrine tumors. We report the case of a man with a mutation in the succinate dehydrogenase subunit B (SDHB) gene, in which an abdominal MRI scan identified two 5-mm left para-aortic nodules, suspect for paragangliomas. Subsequent SPECT revealed increased uptake of tracer. 123I MIBG probe-guided resection was scheduled. During surgery, 2 small nodules with elevated activity in between the superior mesenteric artery and the left adrenal gland were identified by the detection probe and were resected. Histopathologic examination revealed mature ganglioneuromas.
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