Incidental pheochromocytoma presenting with sublaboratory findings in asymptomatic surrenal masses: a case report

Abstract

Introduction: Adrenal incidentaloma can be described as adrenal lesions that are incidentally diagnosed during abdominal laparotomy or any abdominal screening without prior suspicion of adrenal disease. It is important to diagnose adrenal lesions to learn if they are hormonally active or malignant. The most common clinical sign of pheochromocytoma is sustained or paroxysmal hypertension, and the most common symptoms are headache, excessive truncal sweating, and palpitation. In some cases, the clinical symptoms are not clear. Roughly 70% of adrenal incidentalomas are non-functional. A small group of 5-7% of the functional ones (30%) may exist as pheochromocytoma. Ten percent of pheochromocytoma cases are diagnosed incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) screenings for other reasons. The most frequent symptom of the pheochromocytoma is hypertension, and 90-100% of cases exhibit it. The literature indicates that incidental pheochromocytoma cases that are smaller than 1 cm have no clinical symptoms. Rarely, some large pheochromocytoma cases do not show any clinical symptoms, and it is difficult to diagnose very small ones.

Clinically “silent” giant pheochromocytoma. case report

“…Although reported, completely "silent", hormonally inactive, very large and assumably old pheochromocytomas are very rare (1,30,31).…”

“…Due to technological advances the frequency of AI diagnosis increased about 20 times in the last three decades (1). According to autopsy data the incidence of these lesions is age dependent, being 1% of people at age 30, 3% of people older than 50 years of age and 7% at age 70, without difference in gender (2,3).…”

“…The estimated incidence of pheochromocytomas is 0.1% and 0.2% in the general and hypertensive population, respectively (7). They most often occur in the abdomen (90%) and among them 90% are localized in the adrenal glands with the incidence increasing during 4 th and 5 th decades (1).…”

Pheochromocytoma diagnosed pathologically with previous negative serum markers

“…While marker‐negative pheochromocytomas represent a small subset of an already rare tumor, they are not uncommon, and warrant a high level of clinical suspicion in a patient who presents with adrenal incidentaloma. There is little information in the current literature concerning the prevalence and nature of marker‐negative pheochromocytomas, with the majority being case studies of single patients . The primary objective of this analysis was to compare patient characteristics and clinical presentation between marker‐positive and marker‐negative pheochromocytomas.…”

Graves' Disease Accompanied by Pheochromocytoma: Report of a Case

“…However, many case reports have shown that urine catecholamines are normal [22,23]. Ozkaya et al [24] reported a case that …”