Korean J Intern Med.  2006 Jun;21(2):141-145. 10.3904/kjim.2006.21.2.141.

A Case of a Composite Adrenal Medullary Tumor of Pheochromocytoma and Ganglioneuroma Masquerading as Acute Pancreatitis

• Choi EK
• Kim WH
• Park KY

• KMID: 1785614
• DOI: http://doi.org/10.3904/kjim.2006.21.2.141

Abstract

Composite adrenal medullary tumors, composed of both pheochromocytoma and ganglioneuroma, are extremely rare, as are pheochromocytomas masquerading as acute relapsing pancreatitis. We recently experienced a case of a 48-year-old male with both these phenomena. The patient complained of an acute onset of intense abdominal discomfort. At the same time, pancreatic enzymes were increased in concentration. An abdominal computed tomographic scan revealed an enlarged pancreas and a 3-cm left adrenal incidentaloma. Biochemical and 131I-MIBG scintigraphic findings were compatible with a pheochromocytoma. Yet, he had no clinical manifestations suggesting pheochromocytoma. An adrenalectomy was performed and a composite adrenal medullary tumor of pheochromocytoma and ganglioneuroma was confirmed during a pathologic examination. This case illustrates two points: 1) acute abdominal intense discomfort and hyperamylasemia may be unusual presentations of pheochromocytomas; and 2) the possibility of the pheochromocytoma, albeit rare, should be considered when a relapsing pancreatitis of uncertain etiology develops.

Keyword

Adrenal gland neoplasms; Pheochromocytoma; Ganglioneuroma; Hyperamylasemia; Pancreatitis

MeSH Terms

Pheochromocytoma/*diagnosis
Pancreatitis/*etiology
Neoplasms, Multiple Primary/*diagnosis
Middle Aged
Male
Humans
Ganglioneuroma/*diagnosis
*Adrenal Medulla
Adrenal Gland Neoplasms/*diagnosis
Acute Disease