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Adrenal Medullary Hyperplasia with Coexisting Adrenal Cortical Adenoma

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초록

Adrenal medullary hyperplasia is an increase in the mass of the adrenal medullary cells. We report a case of a 38-year-old man presenting with pheochromocytoma-like symptoms who was preoperatively misdiagnosed with pheochromocytoma. Hypertension was associated with an intracranial hemorrhage evident in a brain computed tomography scan, in which no obvious pituitary gland enlargement was detected. An abdominopelvic CT revealed a solitary tumor in the right adrenal gland with no obvious enlargement of the contralateral adrenal gland or sympathetic chains. Lab results showed increased levels of urinary metanephrines. Based on clinical data, the patient underwent a laparoscopic right adrenalectomy bases on a diagnosis of pheochromocytoma. The patient was finally diagnosed with adrenal medullary hyperplasia with coexisting ipsilateral non-functioning adrenal cortical adenoma. Postoperatively, blood pressure and lab results were maintained in the normal range and the patient was symptomatically free during the follow-up period. (Korean J Endocrine Surg 2011;11: 182-185)

Abstract

Adrenal medullary hyperplasia is an increase in the mass of the adrenal medullary cells. We report a case of a 38-year-old man presenting with pheochromocytoma-like symptoms who was preoperatively misdiagnosed with pheochromocytoma. Hypertension was associated with an intracranial hemorrhage evident in a brain computed tomography scan, in which no obvious pituitary gland enlargement was detected. An abdominopelvic CT revealed a solitary tumor in the right adrenal gland with no obvious enlargement of the contralateral adrenal gland or sympathetic chains. Lab results showed increased levels of urinary metanephrines. Based on clinical data, the patient underwent a laparoscopic right adrenalectomy bases on a diagnosis of pheochromocytoma. The patient was finally diagnosed with adrenal medullary hyperplasia with coexisting ipsilateral non-functioning adrenal cortical adenoma. Postoperatively, blood pressure and lab results were maintained in the normal range and the patient was symptomatically free during the follow-up period. (Korean J Endocrine Surg 2011;11: 182-185)

참고문헌 (7)

  1. Rudy FR, "Adrenal medullary hyperplasia: a clinicopathologic study of four cases", Hum Pathol, 11, pp.650~657 (1980)
  2. Kim HS, "A case of concomittantly occurred bilateral adrenal medullary hyperplasia and a ganglioneuroma near the left adrenal gland", J Korean Soc Endocrinol, 6, pp.259~265 (1991)
  3. Case records of the Massachusetts General Hospital, "Weekly clinicopathological exercises. Case 6-1986. A 34-year-old man with hypertension and episodes of flushing, nausea, and vomiting", N Engl J Med, 314, pp.431~439 (1986)
  4. Yoshioka M, "Adrenomedullary hyperplasia associated with cortisol producing adenoma", Endocr J, 40, pp.467~471 (1993)
  5. Nomikos IN, "Association of an oversized adrenal cortical adenoma with expression of pheochromocytoma-like neurosecretory features", J BUON, 13, pp.425~428 (2008)
  6. Yotsuyanagi S, "A case of adrenal pheochromocytoma with contralateral adrenocortical adenoma", Hinyokika Kiyo, 47, pp.89~93 (2001)
  7. Kopetschke R, "Frequent incidental discovery of phaeochromocytoma: data from a German cohort of 201 phaeochromocytoma", Eur J Endocrinol, 161, pp.355~361 (2009)

관련 논문AI추천

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