Endocrine Abstracts

Introduction: Adrenal tumors present with clinical features and signs unique to their specific hormonal hypersecretion. Among adrenal tumors, oncocytic pheochromocytomas are exceedingly rare tumours. We report an unusual clinical presentation of an adrenal cortical tumor with histologic features of an oncocytic pheochromocytoma.

Case Report: We present a case of a 64-year-old man with moderate hypertension, type 2 diabetes and an incidental adrenal mass on radiological investigations. The patient had high levels of 24-hour urine metanephrines and normetanephrines: 13 (normal: <0.9 nmol/l). A CT scan of the abdomen revealed a 76 × 64 mm hypodense solid lesion in the right adrenal gland. The tumour was subsequently excised. Macroscopic examination revealed a yellow-buff mass of the adrenal gland measuring 100×70×55 mm and 151 g. Histologically, the tumour cells showed oncocytic appearance with high-grade nuclear abnormalities (nécrosis) and foci of extension into the peri-adrenal fat. Immunohistochemical studies revealed that the tumour was positive for chromogranin and synaptophysin and negative for cytokeratin. The malignant potential of pheochromocytoma is known to be difficult to predict. scoring system used was PASS (phaeochromocytoma of adrenal scaled score) by Thompson, which schowed that the tumour had a malignant potential.

Conclusion/Discussion: Oncocytic phaeochromocytoma should be in the differential diagnoses of oncocytic tumours of the adrenal gland. The majority of neoplasms are benign and should not be misdiagnosed as carcinoma\..