Pediatric Pheochromocytoma

Etiology: Catecholamine-secreting tumor derived from chromaffin cells
Imaging:
— Solid adrenal mass
Note: No evidence that IV administration of modern (non-ionic) iodinated or gadolinium-based contrast material increases the risk of hypertensive crisis in patients with pheochromocytoma
DDX:
Complications:
Treatment: Surgical
Clinical:
— Elevated metabolites of norepinephrine and epinephrine (normetanephrine and metanephrine)
— When found outside adrenal gland are called paraganglioma

Radiology Cases of Pheochromocytoma

CT of pheochromocytoma — Axial CT without contrast of the abdomen shows a large solid right adrenal mass.

CT of pheochromocytoma — Axial CT with contrast of the abdomen shows a small, oval, homogeneously mildly enhancing solid lesion in the left adrenal gland just anterior to the left kidney.

Radiology Cases of Paraganglioma

CT of paraganglioma — Axial CT with contrast of the abdomen shows a solid, enhancing, round, heterogenous mass anterior to and between the aorta and inferior vena cava.

Surgery Cases of Pheochromocytoma

Surgery image of pheochromocytoma — Surgical image shows a 6 cm dumbbell shaped tumor that was adherent to the inferior vena cava with tumor extension via the adrenal vein into the inferior vena cava. The dark ovoid mass in the center of the image is the main portion of the tumor. The glistening white smaller mass is a portion of the tumor inside the lumen of the opened inferior vena cava. Vascular clamps are on the inferior vena cava above and below the tumor.

Surgery Cases of Paraganglioma

Surgery image of paraganglioma — Surgical image shows a rounded mass inferior to the liver, in the midline of the abdomen, located between the aorta (on the left of the image) and the inferior vena cava (on the right of the image).

Gross Pathology Cases of Pheochromocytoma

Gross pathology image of pheochromocytoma — Gross pathological image shows an adrenal mass that was 3 x 3 x 2.5 cm in size, brown in color, dumbbell in shape, and completely surrounded by a thin fibrous capsule.

Gross pathology image of pheochromocytoma — Sectioned gross pathological image shows an ovoid gray to tan mass with a compressed, residual adrenal gland superiorly (to the left of the image).

Gross Pathology Cases of Paraganglioma

Gross pathology image of pheochromocytoma causing ureteropelvic junction obstruction — Sectioned gross pathological image shows an ovoid gray to tan mass surrounded by a thin fibrous capsule that is compressing the right ureter resulting in right hydroureteronephrosis.

Histopathology Cases of Pheochromocytoma

Histopathology image of pheochromocytoma — Histopathological image H&E stained section shows nests of cells with variably sized nuclei and abundant, lightly eosinophilic cytoplasm; the nests of cells are frequently separated by conspicuous vascular spaces.