Biochemically Silent Pheochromocytoma in an Asymptomatic Patient With a Unilateral Lipid-Poor Adrenal Adenoma.

Autor:	Hussain A; Internal Medicine, Appalachian Regional Healthcare, Harlan, USA., Thota Kammili S; Internal Medicine, Appalachian Regional Healthcare, Whitesburg, USA., Uy E; Diabetes and Endocrinology, Appalachian Regional Healthcare, Whitesburg, USA., Piercy J; Internal Medicine, Appalachian Regional Healthcare, Whitesburg, USA., Ganti S; Internal Medicine, Appalachian Regional Healthcare, Harlan, USA., Gullapalli D; Internal Medicine, Appalachian Regional Healthcare, Harlan, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Oct 16; Vol. 15 (10), pp. e47120. Date of Electronic Publication: 2023 Oct 16 (Print Publication: 2023).
DOI:	10.7759/cureus.47120
Abstrakt:	In this case, a Caucasian woman was incidentally found to have a left adrenal gland incidentaloma a decade ago. Initial tests indicated a non-functional lipid-poor adenoma, but ongoing surveillance revealed irregularities in biochemical testing for pheochromocytoma. The patient was concurrently taking an SNRI, known to elevate biochemical markers artificially. Given the adenoma's growth and mild biochemical abnormalities, laparoscopic surgery was performed, and the tumor was found to be a 2.4 cm × 1.8 cm pheochromocytoma. Following the procedure, hormone levels normalized, and the patient experienced relief from symptoms. This case underscores the rarity of pheochromocytomas, emphasizing the importance of accurate diagnosis and effective management. Imaging techniques, notably computed tomography (CT) and magnetic resonance imaging (MRI), played a crucial role in localization, particularly through contrast-enhanced methods. Key characteristics like Hounsfield density, enhancement patterns, and washout behavior aided in distinguishing diverse adrenal masses. For cases where imaging had limitations, complementary techniques such as 23I-metaiodobenzylguanidine (MIBG) scintigraphy, specialized MR sequences, and GA-DOTATATE scans provided supplementary diagnostic insights, collectively contributing to a comprehensive clinical understanding. Despite advancements, challenges persist in differentiating specific adrenal tumors, highlighting the need for continued research and refined imaging methodologies. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Hussain et al.)
Databáze:	MEDLINE
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