PMC8020182_01
a: Ultrasonography showing a 6.8x3.9 cm heterogeneous lesion on right adrenal suggestive of an adrenal neoplasm. 1b: Contrast-enhanced computed tomography showing the arterial phase hyperenhancing lesion with dimensions of 5.4x6.3x6.4 cm in right suprarenal location suggestive of pheochromocytoma. 1c: Showing the intra-operative images of pheochromocytoma.
MEDJ-36-069-f1.jpg
PMC8020182_01_MEDJ-36-069-f1.jpg
F1
However, her abdominopelvic ultrasound revealed a solid mass with fine cystic components of size 7.9x6.8x4.2 cm above her right kidney with a high suspicion of a tumor of adrenal origin (Figure 1a). With these findings, we proceeded with an abdominopelvic contrast-enhanced computed tomography which showed an arterial phase hyperenhancing lesion with dimensions of 5.4x6.3x6.4 cm in the right suprarenal location suggestive of pheochromocytoma (Figure 1b). After two weeks of adrenal suppression with controlled hypertension and with the help of multidisciplinary team comprising of surgeons, anesthesiologist, and endocrinologist, she underwent an uncomplicated laparoscopic adrenalectomy (Figure 1c).
a: H&E, 40x, Well circumscribed tumor with compressed peripheral adrenal parenchyma (black arrow). 2b: H&E, 100x, Nests of tumor cells with circumscribed margin and adjacent normal adrenal parenchyma (black arrow). 2c: H&E 100x Nests and trabecular pattern of tumor cells, separated by thin fibrovascular septae. 2d: H&E, 400x, Tumor cells having moderate amount of granular eosinophilic cytoplasm, centrally placed round nucleus with fine granular chromatin and inconspicuous nucleoli. Scattered sustentacular cells (black arrow) are also noted.
MEDJ-36-069-f2.jpg
PMC8020182_01_MEDJ-36-069-f2.jpg
F2
Histologically, the tumor was confirmed to be a pheochromocytoma (Figure 2).