History: 53 yo female, Screening VC
Solution: Pheochromocytoma
Pheos are a rare catecholamine secreting tumor of chromaffin tissue that arises from neuroectodermal tissue. They most frequently occur in the adrenal glands (90%) as in this case, but can occur anywhere there is sympathetic neural tissue. When it occurs in the adrenal gland, it is called a pheo, when it occurs outside the adrenal gland, it is called a paraganglioma and these occur all over the body with the most common locations being paraaortic, organ of Zuckerkandl, gonads, and bladder.
Pheos have the rule of 10\'s.
10% bilateral/multiple. 10% malignant. 10% extra-adrenal. 10% familial.
On imaging, they are usually round well marginated tumors that have various amounts of heterogeneity and calcification depending on associated hemorrhage. They often result in hypertension, although about 10% are asymptomatic and can be associated with life threatening hemorrhage. The differential includes a lipid poor adrenal adenoma, adrenocortical carcinoma, and metastasis.
Pheos are a rare catecholamine secreting tumor of chromaffin tissue that arises from neuroectodermal tissue. They most frequently occur in the adrenal glands (90%) as in this case, but can occur anywhere there is sympathetic neural tissue. When it occurs in the adrenal gland, it is called a pheo, when it occurs outside the adrenal gland, it is called a paraganglioma and these occur all over the body with the most common locations being paraaortic, organ of Zuckerkandl, gonads, and bladder.
Pheos have the rule of 10\'s.
10% bilateral/multiple. 10% malignant. 10% extra-adrenal. 10% familial.
On imaging, they are usually round well marginated tumors that have various amounts of heterogeneity and calcification depending on associated hemorrhage. They often result in hypertension, although about 10% are asymptomatic and can be associated with life threatening hemorrhage. The differential includes a lipid poor adrenal adenoma, adrenocortical carcinoma, and metastasis.
CT Images
