Composite Adrenal Medullary Tumor: A Case Report

DOI: 10.26650/IUITFD.306088 Adrenal neoplasms comprising more than one cell type and demonstrating a mixed histologic appearance are rare. A 57-year-old woman presented with a history of nausea, an increase in the frequency of urination, abdominal pain, and hypertension. Laboratory results revealed elevated urinary dopamine and metanephrine excretion in 24-h urine collection. A 50-mm right suprarenal mass was detected on computed tomography, which was hyperintense on T2-weighted and heterogeneously isointense on T1-weighted images on magnetic resonance imaging. The patient underwent laparoscopic right adrenalectomy. Her perioperative period was uneventful. Histopathologic and immunohistochemical examination showed mixed medullary histologic characteristics for pheochromocytoma and ganglineuroma. Although the capsular and periadrenal adipose tissues were invaded by the tumor, the patient was disease and symptom free at the 5-year follow-up. Composite adrenal medullary tumors are rare, and benign tumors with a distant metastasis have been reported in one patient. Our case also showed a potential malignant behavior in terms of the capsular and periadrenal adipose tissue invasion. It can be concluded that such patients should undergo life-long clinical and biochemical follow-ups