Korean J Urol.  2006 Jul;47(7):797-801. 10.4111/kju.2006.47.7.797.

Malignant Pheochromocytoma that Recurred in the Contralateral Adrenal Gland and Metastasized to the Bladder

• Kim SD
• Kim JH
• Yang SW
• Yang WJ
• Sung LH
• Chung JY
• Noh CH
• Ryu YG
• Kim HY
• Kim SH
• Kim JY

• KMID: 2294326
• DOI: http://doi.org/10.4111/kju.2006.47.7.797

Abstract

Pheochromocytoma is an uncommon neoplasm and it is derived from the neural crest. It is one of the surgically curable hypertensive syndromes. The sequela of this disease can be serious if definite treatment is not promptly performed. We report here on a case of malignant pheochromocytoma that recurred in the contralateral adrenal gland and it subsequently metastasized to the bladder after the patient refused treatment of the contralateral adrenal tumor.

Keyword

Pheochromocytoma; Recurrence; Malignant; Metastasis; Bladder

MeSH Terms

Adrenal Glands*
Humans
Neoplasm Metastasis
Neural Crest
Pheochromocytoma*
Recurrence
Urinary Bladder*

Figure

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  Fig. 1 Abdominal computer tomography taken 10 years before presentation shows a well-defined round mass with peripheral marked enhancement and central necrosis in the anterior portion of the left kidney (white arrowhead).

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  Fig. 2 Microscopic finding of the left adrenal mass lesion that is resected 10 years before. It reveals pheochromocytoma and shows a small alveolar pattern of growth with balls or cords of cells ("Zellballen") that are delimited from each other by connective tissues and vascular septations. Mitotic figures are uncommonly seen (H&E, ×150).

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  Fig. 3 Abdominal computer tomography shows recurrent mass lesion involving the right adrenal gland (7.0×4.2×2.1cm, white arrowhead) (A) and enlargement of the aorto-caval lymph node (3.5×2.1×1.5cm, white arrowhead) (B).

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  Fig. 4 Pelvic computer tomography shows well-enhancing mass lesion between the posterior wall of the bladder and the seminal vesicle (2.8×1.9×1.8cm).

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  Fig. 5 18F-FDG PET shows increased uptakes in the right adrenal gland (white) and the aorto-caval lymph node (black).

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  Fig. 6 Microscopic finding of the right adrenal mass shows an alveolar pattern with distinct nests of cells ("Zellballen"); this is identical to the left adrenal mass lesion that is resected 10 years before (H&E, ×200).

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  Fig. 7 Microscopic finding of the bladder mass shows the same finding as the adrenal mass. The bladder mass is located in the detrusor muscle (arrowheads) (H&E, ×100).

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