Simultaneous adrenal pheochromocytoma and sarcoidosis

A 48-year-old man presented for evaluation of general weakness. Because he had a history of excessive alcohol use, an abdominal computed tomography scan was obtained, which revealed a left adrenal mass. Hormonal evaluation showed elevated levels of urinary catecholamines. Bilateral hilar lymphadenop...

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Published inSouthern medical journal (Birmingham, Ala.) Vol. 102; no. 5; p. 537
Main Authors Kim, Kyoung-Ah, Kim, Se Won, Park, Gunmin, Kwak, Beom Seok, Choi, Jae Sung, Kim, Sun Ho, Yeo, Jeong Seok, Kim, Eo-Jin
Format Journal Article
LanguageEnglish
Published United States 01.05.2009
Subjects
Adrenal Gland Neoplasms - complications
Adrenal Gland Neoplasms - diagnosis
Adrenal Gland Neoplasms - surgery
Adrenalectomy
Catecholamines - urine
Humans
Incidental Findings
Male
Middle Aged
Pheochromocytoma - complications
Pheochromocytoma - diagnosis
Pheochromocytoma - surgery
Sarcoidosis - complications
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Summary:A 48-year-old man presented for evaluation of general weakness. Because he had a history of excessive alcohol use, an abdominal computed tomography scan was obtained, which revealed a left adrenal mass. Hormonal evaluation showed elevated levels of urinary catecholamines. Bilateral hilar lymphadenopathy was detected on a chest radiograph. The suspected diagnosis was asymptomatic pheochromocytoma with sarcoidosis. We performed a mediastinoscopic lymph node biopsy, which was followed by endoscopic adrenalectomy. Histologic tissue analysis confirmed an adrenal pheochromocytoma and sarcoid granulomas in the mediastinal lymph nodes. This case highlights the difficulty in determining the appropriate work up of patients presenting with an adrenal incidentaloma and concomitant systemic disease.
ISSN:1541-8243
DOI:10.1097/SMJ.0b013e3181a06613