Pheochromocytoma in a cystic adrenal mass mimicking primary hydatic cyst
Ayten OĞUZ1, Eren P. ERSOY2, Melike M. SÖĞÜTLÜGİL3, Gülnur GÜLER4, Reyhan ERSOY5, Bekir ÇAKIR5
A 30-year-old female patient admitted with a left sided adrenal mass. She had no episodic hypertensive attack, no complaint of sweating or headache. Physical examination was completely normal. Adrenal MRI revealed a 72×59×75 mm lesion at the left adrenal lodge with septations. The mass was reported as type III hydatid cyst. In contrast, the hemmaglutination test was negative. The eosinophil count was normal. However, urine normetanephrine and vanyl mandelic acid (VMA) were markedly increased. Left adrenalectomy was performed. The patient’s intra-operative and postoperative courses were uncomplicated. The surgical specimen revealed pure cystic pheochromocytoma. Postoperatively the urine normetanephrine and VMA levels returned in to the normal range.
Cystic pheochromocytomas may not present with the classic prodromal symptoms. This case represents an unsuspected presentation of an extremely rare functional cystic neoplasm.