Open AccessComposite pheochromocytoma masquerading as solid-pseudopapillary neoplasm of pancreas
Author(s) -
Gaurav Gupta,
Ravindra Kumar Saran,
Satyajit Godhi,
Siddharth Srivastava,
Sundeep Singh Saluja,
Pramod Kumar Mishra
Publication year - 2015
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v3.i5.474
Subject(s) - medicine , ganglioneuroma , pheochromocytoma , histopathology , exploratory laparotomy , pancreas , pathology , radiology , abdomen , paraganglioma , anatomy , neuroblastoma , genetics , biology , cell culture
Pheochromocytoma and ganglioneuroma form rare composite tumours of the adrenal medulla comprising less than 3% of all sympathoadrenal tumours. We present a case of intraoperatively detected adrenal medullary tumour of composite pheochromocytoma and ganglioneuroma diagnosed on histopathology, in a normotensive patient. A 50-year-old male with a past history of chronic obstructive pulmonary disease presented with abdominal pain and significant weight loss since one month. Ultrasound and contrast-enhanced computed tomography abdomen revealed a large lobulated lesion in the distal body and tail of pancreas suggestive of solid and papillary neoplasm of body and tail of pancreas. Intra-operatively, a 15 cm × 10 cm solid lesion with cystic areas was seen arising from the left lower pole of the adrenal gland pushing the pancreas which appeared unremarkable. In our case, exploratory laparotomy with tumour excision was done. Extensive sectioning and microscopic examination of this adrenal tumour confirmed a diagnosis of composite Pheochromocytoma with Ganglioneuroma on histopathology. Immunophenotyping with S-100 further supported the diagnosis. The goal of this report is to increase the awareness of this rare disease and to further identify its variable presentation.