PMC7533747_01
CT scan showing a 2.6 cm left adrenal mass.
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In 2016, adrenal CT (Figure 1) showed the mass had increased to 2.6 cm, with an attenuation of 40 HU.
123I-metaiodobenzylguanidine (MIBG) scintigraphy scan showed abnormal focalintense radiotracer accumulation in the left adrenal lesion
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A 24-hour urine metanephrine level was normal at 160 mcg (ref 45-290), while a 24-hour urine normetanephrine level was elevated at 1415 mcg (ref 82-500). An 123I-metaiodobenzylguanidine (MIBG) scintigraphy scan revealed abnormal focal intense radiotracer accumulation in the left adrenal lesion (Figures 2(a) and 2(b)).
Histology demonstrates the well-circumscribed nature of the typical pheochromocytoma. There is an abrupt and distinct border between the pheochromocytoma on the left and the surrounding normal adrenal gland on the right. The tumor has the typical low-power architecture with cells arranged in nests and cords.
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A 3.0 x 2.6 x 2.5 cm left adrenal pheochromocytoma was confirmed on histology (Figure 3).