Clinically silent pheochromocytoma presenting as an adrenal incidentaloma: the importance of biochemical evaluation.
Saraswathi Saiprasad, Narayana Swamy
✦ AI-curated · Sources linked
Case in brief
A woman in her late 70s presented with a 5 cm left adrenal mass found incidentally during imaging for unrelated issues. Despite well-controlled hypertension and no classic symptoms of catecholamine excess, biochemical tests showed elevated plasma free metanephrines, confirming pheochromocytoma. Surgical resection led to a biochemical cure, emphasizing the need for thorough evaluation of adrenal incidentalomas.
Diagnostic / clinical pearl
Clinicians should consider biochemical evaluation for adrenal incidentalomas, even in asymptomatic patients, to rule out pheochromocytoma.
Why it matters
This case underscores the potential for pheochromocytoma to present without classic symptoms, particularly in older patients, highlighting the importance of vigilance in diagnosis.