A Rare Case of Giant Malignant Pheochromocytoma

Abstract

A pheochromocytoma (PCC) is a tumor that arises from an embryonic neural crest and produces catecholamines at high levels. The mean size of these tumors is approximated to be around 7.2 cm, with an average weight of 222 g. In this case, a 61-year-old female patient was referred to our medical center to investigate multiple episodes of hypertensive crisis associated with a huge 18 cm right adrenal mass identified on a computed tomography (CT) scan and magnetic resonance imaging (MRI). Twenty-four-hour urine analysis and blood level exhibited elevated total metanephrine and normetanephrine levels. Mass resection was performed via laparotomy en bloc. Histopathological analysis of the resected specimen confirmed PCC of the right adrenal gland weighing 1900 g. The Adrenal gland Scaled Score (PASS) was 13. PCC may reach sizes much larger than the average observed in the literature and size tends to be positively correlated to malignancy.