PMC5370478_01
CT scan showing a 23 cm, thick-walled, multicystic mass occupying most of the left upper quadrant of the abdomen.
CRIONM2017-4638608.001.jpg
PMC5370478_01_CRIONM2017-4638608.001.jpg
fig1
Computed tomography (CT) revealed a 23.2 x 17.6 x 13.6 cm mass with predominant areas of necrosis, punctate areas of calcification, and irregular contours superior to the left kidney (Figures 1 and 2).
Coronal CT image demonstrating the mass displacing the left kidney inferiorly. Evidence of locally invasive disease was not present.
CRIONM2017-4638608.002.jpg
PMC5370478_01_CRIONM2017-4638608.002.jpg
fig2
Computed tomography (CT) revealed a 23.2 x 17.6 x 13.6 cm mass with predominant areas of necrosis, punctate areas of calcification, and irregular contours superior to the left kidney (Figures 1 and 2).
En bloc resection of the left adrenal mass, pancreatic tail, spleen, and left kidney.
CRIONM2017-4638608.003.jpg
PMC5370478_01_CRIONM2017-4638608.003.jpg
fig3
The mass was completely resected en bloc with the spleen, distal pancreas, left kidney, and a 2 cm area of the left hemidiaphragm (Figure 3). Pathological examination of the surgical specimen revealed a circumscribed mass, surrounded by a variably thick fibrous capsule/pseudocapsule with relatively scantly attached fat, measuring 27 x 18 x 12 cm and weighing 3,315 g (Figure 3).
Microscopic images of pheochromocytoma. (a) Routine hematoxylin and eosin (H&E) staining at low magnification (20x) highlights the typical "Zellballen" growth pattern characterized by nests of tumor cells surrounded by delicate fibrovascular stroma. (b) Immunohistochemistry for the neuroendocrine marker chromogranin A shows strong, diffuse staining in the tumor cells.
CRIONM2017-4638608.004.jpg
PMC5370478_01_CRIONM2017-4638608.004.jpg
fig4
Histological sections revealed typical morphological features of PCC predominantly characterized by nests of plump tumor cells with abundant basophilic granular cytoplasm surrounded by sustentacular cells (Figure 4(a)). Immunohistochemical staining revealed that the tumor cells were diffusely positive for chromogranin A (Figure 4(b)), while there was no significant highlighting of sustentacular cells by S-100.