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A 33-year-old male with a history of nonspecific back pain and associated paraspinal mass, now presenting with lower back and lower left extremity pain with stiffness. Positron emission tomography demonstrated the known lumbosacral paraspinal mass with intense metabolic activity (arrow–A). Anterior (left) and posterior (right) projections of a meta-[123I]-iodobenzylguanidine (MIBG) SPECT-CT demonstrate the large mass with avid MIBG uptake (arrow–B).
