PMC6855059_01
Abdominal MRI scan showing bilateral phaeochromocytoma. (a) axial TSE-T2W images with and without fat suppression; (b) axial GRE-T1W images prior to and 35 s after contrast injection; (c) DWI and ADC map showing restricted diffusion (ADC = 0.6 x 10-3 mm2/s).
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Magnetic resonance imaging (MRI) (Figure 1) revealed bilateral adrenal masses, 37 mm right and 49 mm left.
123I-MIBG SPECT/CT showing increased uptake of the tracer in both adrenal glands, with right predominance.
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In oppossite, cystic components demonstrated high signal. 123I-MIBG SPECT/CT (Figure 2) showed increased uptake foci in both adrenal glands, with right predominance, compatible with the diagnosis of bilateral PCC.
Bilateral phaeochromocytoma. Both right (a, c, d) and left (b, e, f) adrenal tumours were similar in the macroscopic and microscopic appearance. Microscopically they showed the typical nested pattern (c, e), moderate pleomorphism and occasional intracytoplasmic hyaline globules (arrows), but no mitotic activity. S100 sustentacular cells (d) and positivity for chromogranin A (f) were demonstrated. The Ki-67 was less than 2%.
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Both tumours also showed a fleshy, tan cut surface, with haemorrhage areas, measuring 4.5 cm and 5.4 cm maximum diameter in the right and left glands respectively (Figure 3).