Bilateral pheochromocytoma: A case report

Abstract

Pheochromocytoma is a rare tumor developed at the expense of chromaffin cells, the adrenal involvement is most often unilateral. But, in 10% of cases, a bilateral localization is observed. We report the case of a 62-year-old patient, without personal or family pathological history, was hospitalized for exploration of recurrent pain in the right hypochondrium. On examination, the patient reported headaches, palpitations and sweating, on biological examination, urinary methoxylates were elevated, adrenal CT showed a large tissue mass, with fine calcifications and central necrosis, measuring 12*12*8.2cm with a washout <50%, the MEN 1 test was negative, the genetic study was not available, the diagnosis of sporadic right pheochromocytoma was the most likely, The patient underwent a right surrenalectomy with anatopathological examination in favor of pheochromocytoma, in the framework of follow-up a MIBG scan was done at 1 year post-op, it showed the presence of a focus of abnormal and isolated capture opposite the left arm of the left adrenal measuring 10.8*8.3 mm, in favor of a pheochromocytoma, the patient was operated: left adrenalectomy and the anatomopathological examination was in favor of pheochromocytoma. In these patients with bilateral pheochromocytoma, an underlying genetic disorder can be diagnosed in 80% of cases. It is most often a multiple endocrine neoplasia type 2, apart from the genetic aspect of the disease, the discovery of bilateral involvement requires confirmation of the secretory or functional character of the two adrenal masses in view of the possibility of the association of a pheochromocytoma and an incidentaloma of another nature.