Pheochromocytoma

Case contributed by Dr Henry Knipe

Presentation

Flank pain.

Patient Data

Age: 23
Modality: CT

Left adrenal tumour measures 6.5 cm. Central hypodensity and calcification with vivid peripheral enhancement. 

Normal right adrenal gland. No lymphadenopathy. Remainder of the study unremarkable. 

Case Discussion

Patient underwent a Gatate PET-CT (not shown) and the mass demontrated uptake, consistent with a neuroendocrine tumour. The patient proceeded to adrenalectomy.

Histopathology report

MACROSCOPIC DESCRIPTION: "Left adrenal gland tissue": The specimen consists of multiple fragments of adipose tissue and adrenal gland weighing 95 g and measuring 150 x 85 x 34 mm in aggregate. In some fragments, an encapsulated cream tumour is identified. Elsewhere, there are fragments of yellow normal appearing adrenal gland. Macroscopically, no definite capsule breach is present, however, this is difficult to assess due to the fragmented nature of the specimen.

MICROSCOPIC DESCRIPTION: Sections show an encapsulated tumour and adjacent fibroadipose tissue. Tumour consists of nests of cells of varying size, divided by numerous slit-like vascular spaces and fibrous tissue. Cells are spindle to epithelioid and have moderately large, moderately pleomorphic round to oval nuclei with vesicular chromatin and vacuolated amphophilic cytoplasm. There is extensive tumour necrosis with some calcification. There is no definite lymphovascular or perineural invasion. Mitoses are not identified. Margins cannot be assessed.

By immunohistochemistry the tumour cells are positive for chromogranin, synaptophysen, CD56 and AE1/3 and negative for calretinin, inhibin and melanA. S100 shows scattered staining in rare single cells.

DIAGNOSIS: Left adrenal gland tissue: Phaeochromocytoma.

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Case Information

rID: 51399
Case created: 14th Feb 2017
Last edited: 16th Feb 2017
System: Urogenital
Inclusion in quiz mode: Included

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