ECE2016 Eposter Presentations Adrenal medulla (13 abstracts)
Asymptomatic ‘giant’ pheochromocytoma discovered as adrenal incidentaloma
Danijela Radojkovic 1 , Milan Radojkovic 2 , Milica Pesic 1 , Sonja Kostic 1 , Sanja Curkovic 1 , Sasa Radenkovic 1 , Slobodan Antic 1 & Ivan Ilic 3
1Clinic of Endocrinology, Diabetes and Metabolic Disorders, Clinical Center, Nis, Serbia; 2Surgery Clinic, Clinical Center, Nis, Serbia; 3Pathology Institute, Clinical Center, Nis, Serbia.
Introduction: Adrenal incidentalomas are defined as adrenal lesions incidentally discovered during radiological imaging of the abdomen without prior suspicion of adrenal disease. Approximately 70% of adrenal incidentalomas are non-functional adenomas. Pheochromocytoma presents only 5–7% of the remaining functional incidentalomas. Asymptomatic pheochromocytoma-incidentaloma is usually smaller than 1 cm. Large pheochromocytoma, incidentally found, without any clinical signs such as sever hypertension, headache, sweating and tachycardia are very rare.
Patient case report: Herein, we present young woman (32 years old) admitted to Endocrinology Clinic, after incidentally discovered right adrenal mass, size 60×70 mm, on abdominal sonogram, performed during regular systematic examination. Computed tomography confirmed ‘giant’ tumour, size 70×74 mm, with cystic and necrotic areas and inhomogeneous contrast captivity.
Endocrine evaluation of the patient verified normal cortisol, ACTH, vanillylmandelic acid in 24 h diuresis, plasma catecholamine and chromogranin serum level. Electrolytes (sodium, potassium, calcium phosphorus, magnesium) were in normal range.
The patient underwent [131I]-meta-iodobenzylguanidine ([131I]-MIBG) scan which revealed large area of increased uptake above the right kidney indicating giant right adrenal pheochromocytoma. After adequately preoperative preparation, right adrenalectomy was performed. The procedure and postoperative course were uneventful. The histopathological examination confirmed pheochromocytoma.
Conclusion: Due to technological advances the frequency of adrenal incidentaloma diagnosis is constantly increasing. Every incidentally found adrenal mass has to be carefully examined regardless of its clinical presentation in order to prevent fatal oversight of possible secreting nature and/or malignant potential of the lesion and to ensure an adequate curable treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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