Kosin Med J.  2018 Dec;33(2):215-222. 10.7180/kmj.2018.33.2.215.

Adrenal incidentaloma: a case of asymptomatic pheochromocytoma

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, Busan, Korea. choisr@dau.ac.kr

Abstract

An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

Keyword

Adrenal incidentaloma; Extracorporeal membrane oxygenation (ECMO); Hypertensive crisis; Pheochromocytoma; Pulmonary edema

MeSH Terms

Autopsy
Cardiopulmonary Resuscitation
Humans
Kidney
Membranes
Multiple Organ Failure
Pheochromocytoma*
Pulmonary Edema
Sepsis
Tachycardia
Thyroid Gland

Figure

  • Fig. 1 Upper abdominal ultrasonography. At the preoperative evaluation, 4.86 cm round solid mass in the left abdomen medial to the left kidney on upper abdomen was detected.

  • Fig. 2 The patient's initial ECG shows T wave


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