PMC8041535_01
Computed tomography findings on admission. Contrast-enhanced coronal abdominal computed tomography showed a left 5.7 cm adrenal mass (red dots) and a large retroperitoneal hemorrhage.
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Abdominal computed tomography revealed a left 5.7 cm adrenal mass with a large retroperitoneal hemorrhage (Figure 1), and the patient was transferred to our hospital for multidisciplinary treatment.
Change in imaging findings. (a) Contrast-enhanced axial computed tomography on admission indicated a left adrenal mass and a large retroperitoneal hemorrhage (red dots). (b) T1-weighted magnetic resonance imaging after a month discharge showed tumor shrinkage of a left adrenal mass and the reduction of hematoma (red dots). (c) Plain axial computed tomography three months after discharge indicated a 2.8 cm left adrenal mass and hematoma (red dots). (d) T1-weighted magnetic resonance imaging five months after discharge showed even more tumor shrinkage and the reduction of hematoma (red dots).
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The tumor sizes were 3.1, 2.8, and 1.3 cm one month, three months, and five months after discharge, respectively (Figure 2).
Time course of clinical data. Blood pressure was well controlled with a significant decrease in plasma levels of catecholamines as the tumor size decreased after TAE. MN, levels of plasma metanephrine; NMN, levels of plasma normetanephrine.
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Tumor shrinkage prompted us to resect the tumor laparoscopically (Figure 3).
Histopathological findings of the resected adrenal gland. (a) The cut surface of the tumor. The left adrenal tumor (a double-headed yellow arrow) measured 13 mm x 12 mm x 11 mm. (b) The section showed the large and irregular cell nest arrangement of tumor cells (hematoxylin and eosin x 400). (c) The brown staining showed the expression of chromogranin A in the tumor x 200.
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Pathological findings confirmed the diagnosis of an adrenal pheochromocytoma (Figure 4).