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Case report
Adrenal medullary hyperplasia mimicking pheochromocytoma
  1. Annalisa Montebello1,2,
  2. Michelle Ann Ceci3 and
  3. Sandro Vella1,2
  1. 1Diabetes and Endocrinology Department, Mater Dei Hospital, Msida, Malta
  2. 2Department of General Internal Medicine, Mater Dei Hospital, Msida, Malta
  3. 3Pathology Department, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Annalisa Montebello; a.montebello{at}


A 59-year-old woman, a known case of hypertension, was incidentally diagnosed with a large right-sided adrenal mass. Investigations for a functional adrenal lesion resulted in very high preoperative norepinephrine levels. A right adrenalectomy was performed. Histology showed adrenal medullary hyperplasia (AMH). AMH is a rare diagnosis and its incidence is poorly documented in the literature. This is a benign entity which resembles pheochromocytoma (PCC) in both clinical and biochemical manner. AMH is usually bilateral and may occur in isolation or in association with PCC. In fact, some authors consider it to be a precursor to PCC. Thus, these patients need long-term follow-up in view of the risk of development of PCC later.

  • adrenal disorders
  • radiology
  • general surgery

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  • Contributors AM and MAC have written up the case under continuous supervision of SV. AM discussed the case presentation, investigations and management, while MAC prepared the histology slides and discussed the pathology of this case.

  • 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.

  • Patient consent for publication Obtained.

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

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