The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 2
A pheochromocytoma case diagnosed as adrenal incidentaloma
Doğuş Vurallı 1 ,Nurgün Kandemir 1 ,Graeme Clark 2 ,Diclehan Orhan 3 ,Ayfer Alikaşifoğlu 1 ,Nazlı Gönç 1 ,Saniye Ekinci 4 ,Alev Özön 1
1 Division of Pediatric Endocrinology Departments of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
2 University of Cambridge and NIHR Cambridge Biomedical Research Center, Department of Medical Genetics, Cambridge, United Kingdom
3 Departments of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
4 Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
DOI : 10.24953/turkjped.2017.02.015 Vurallı D, Kandemir N, Clark G, Orhan D, Alikaşifoğlu A, Gönç N, Ekinci S, Özön A. A pheochromocytoma case diagnosed as adrenal incidentaloma. Turk J Pediatr 2017; 59: 200-206.

There are two problems that needs to be addressed in cases of an adrenal incidentaloma. The first is to decide whether the adrenal mass is benign or malignant, and the second is to determine whether the mass is hormonally active or not. A 17-year-old male was admitted with the complaint of progressive weight gain. Abdominal ultrasonography was performed for elevation in transaminases which revealed a hypoechoic mass located in the left adrenal gland. Hormonal investigations revealed an increase in fractionated catecholamine and metanephrine levels in 24-hour urine. Surgery was performed and pathological examination was in accordance with pheochromocytoma. Mutation analysis was carried out. This is a rare case of pheochromocytoma presenting as adrenal incidentaloma during adolescence. In view of this case, we review the approach to incidentally discovered adrenal masses and the approach to pheochromocytoma. A mutation analysis should be performed on all cases with pheochromocytoma that are diagnosed below age 20. Keywords : adrenal glands, adrenal gland neoplasms, adrenal incidentaloma, pheochromocytoma

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