Pediatric Pheochromocytoma

  • Etiology: catecholamine-secreting tumors derived from chromaffin cells, when found outside adrenal gland are called paraganglioma
  • Imaging: solid adrenal mass
  • Clinical: elevated metabolites of norepinephrine and epinephrine (normetanephrine and metanephrine), 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

Radiology Cases of Pheochromocytoma

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

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.