Presentation
Work up for the left flank pain.
Patient Data
A large thick-walled multiloculated cystic mass is seen at the left adrenal gland that contains eccentric enhancing soft tissue components. There is no sign of local invasion and no regional lymphadenopathy.
The attenuation value of the liver is less than the spleen, suggesting fatty liver.
The prostate gland is enlarged.
The patient underwent left adrenal mass resection, and further histopathology evaluation and IHC confirmed benign pheochromocytoma.
Case Discussion
Pheochromocytoma most frequently arises from the adrenal medulla. However, about 10% of the masses are extra-adrenal and can be found along the sympathetic chain in the urinary bladder and organ of Zuckerkandl.
It is may not possible to distinguish malignant from benign pheochromocytomas merely on the direct appearance of the mass. However, direct tumor invasion into adjacent structures or the presence of metastases suggests a malignant lesion.
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