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Case report
Simple adrenal cyst masquerading clinically silent giant cystic pheochromocytoma
  1. Santosh Kumar1,
  2. Kalpesh Mahesh Parmar1,
  3. Dharmender Aggarwal1 and
  4. Kiran Jhangra2
  1. 1 Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2 Anaesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Kalpesh Mahesh Parmar, kalpesh010385{at}gmail.com

Abstract

Pheochromocytoma (PCC) may present as a cystic or solid tumour. Cystic PCCs are difficult to differentiate from simple cysts in the absence of classic symptoms of PCCs. Cystic nature develops due to intralesional bleeding and necrosis. We present a case of young man without any comorbidity who was diagnosed as a simple adrenal cyst and planned for laparoscopic excision but found to be functional PCC during the time of surgery only. The patient was managed with extensive monitoring and use of multiple drugs to control blood pressure. Surgery was completed without any complication laparoscopically and postoperative period was also uneventful. Histopathology confirmed the diagnosis of cystic PCC. Our case also shows the importance of functional imaging like metaiodobenzylguanidine (MIBG) scan in doubtful cases of adrenal cysts when other biochemical markers are unremarkable to diagnosis. We emphasise the importance of meticulous preparation for any intraoperative disasters even for apparently simple adrenal cyst.

  • hypertension
  • radiology (diagnostics)
  • adrenal disorders
  • urological surgery
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Footnotes

  • Contributors DA and KMP collected data and wrote initial draft. KJ critically analysed the manuscript. SK made final proof reading and correction.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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