Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website http://www.jofem.org

Case Report

Volume 4, Number 1-2, April 2014, pages 39-46

An Unusual Case of a Composite Pheochromocytoma With Neuroblastoma

Figures

Figure 1.
Figure 1. CT images of the abdomen. Axial (A) and coronal (B) images from a non-contrast-enhanced CT scan of the abdomen. Note the 5.8× 5.0 cm mass in the left adrenal gland (white arrows).
Figure 2.
Figure 2. Pathology of the left adrenal tumor. The enlarged adrenal gland (80 g) was replaced by a homogenous red brown tumor, the majority of which was a typical pheochromocytoma composed of polygonal cells with abundant eosinophilic cytoplasm and scattered enlarged bizarre cells (A). Pheochromocytoma merged with microscopic foci of small round blue cells (white arrow), these comprising < 5% of the tumor and not evident grossly (B). The nests of immature neuroblast cells showed a low MKI (C).

Tables

Table 1. Initial 24-H Urine for Fractionated Catecholamines and Metanephrines
 
TestResultReference range
Epinephrine742 nmol< 100 nmol/day
Norepinephrine589 nmol< 500 nmol/day
Dopamine3,179 nmol< 2,600 nmol/day
Normetanephrine7.3 µmol< 3.3 µmol/day
Metanephrine19.9 µmol< 1.7 µmol/day
VMA70 µmol6 - 36 µmol/day

 

Table 2. Preoperative Plasma Free Metanephrines and Chromogranin A
 
TestResultReference range
Chromogranin A242 U/L< 21 U/L
Plasma free metanephrine3.34 nmol/L< 0.50 nmol/L
Plasma free normetanephrine6.09 nmol/L< 0.90 nmol/L