Endocrine Abstracts

Introduction: Pheochromocytoma is a rare tumor originating from the embryonic neural crest and secreting high levels of catecholamines. The average pheochromocytoma size is 7 cm in the previous publications (1). Sometimes these tumors may be bigger. In this abstract, a case of pheochromocytoma with a huge size presented with unusual presentation.

Case study: Fifty-six year-lady presented with an incidental finding of suprarenal mass 14.5 cm after an investigation for recurrent non-specific abdominal pain. Her CT abdominal scan showed large right suprarenal mass. Further exploration of her history; she denied all symptoms of pheochromocytoma. She has no symptoms of a headache, palpitations, sweating, tremors, dyspnea, anxiety or other symptoms related to pheochromocytoma. Her urine metanephrines showed persistently elevated normetanephrine of 9.5 and 9.73 umol/24 hrs urine (normal is less than 3 umol/24 hrs urine collection). All her other baseline blood results are normal including bone profile and glucose. After the biochemical diagnosis of pheochromocytoma, the patient was referred to a tertiary centre where all the other workup is done. After review of online English literature and as far as we know, this case is the twelfth largest pheochromocytoma reported in the English literature (2) and the largest published in the UK.

Summary and conclusion: • Most giant pheochromocytomas do not present with classic symptoms.

• Pheochromocytoma may reach huge sizes without causing any symptoms (1).

• No clear correlation between the size of a tumour and the catecholamines level.

References: 1. Giant multicystic malignant pheochromocytoma. Turk J Surg. 2017; 33(4): 296–298.Erdal Uysal,¹ Türkay Kırdak,² Ahmet Orhan Gürer,¹ and Mehmet Ali İkidağ³.

2. Largest pheochromocytoma reported in Canada: A case study and literature review. Can Urol Assoc J. 2014 May-Jun; 8(5-6): E374–E377. Druvtej Ambati,^* Kunal Jana, MD, FRCSC,^† and Trustin Domes, MD, MEd, FRCSC^†.