CT Features of Adrenal Pheochromocytoma: Evaluation with Clinical and Pathological Correlation

Abstract

Objective: To evaluate CT features of adrenal pheochromocytoma with clinical and histopathological correlation.

Methods: A retrospective study was approved by the ethics committee. Forty-four patients with proven adrenal pheochro-mocytoma from January 2002- December 2007 at our institution were included. Only 10 out of the 44 had available pre-operative computed tomography (CT). All 10 CT were interpreted independently by two abdominal radiologists, with correlation with clinical and histopathological analysis.

Results: All 10 patients had unilateral adrenal pheochromocytoma. Three were men and 7 were women. The mean age of patients was 45.1 years old. Eight out of 10 patients presented with hypertension. Four patients presented with neuroendocrine symptoms such as palpitation and diaphoresis. Other symptoms were palpable abdominal mass, headache and gastrointestinal symptoms (nausea, vomiting or abdominal pain). Pre-operative biochemistry tests for pheochromocytoma were performed in 8 patients. The tumor size varied from 2-15 cm in diameter. CT features of pheochromocytoma of this study showed 1 tumor of pure solid mass (2 cm tumor size) and 9 tumors of complex cystic masses. The range of density values at the solid part of tumors was 25-53 HU on non-contrast phase CT and the mean was about 41.4 HU. All 10 tumors showed enhancement of the solid part. Intratumoral hemorrhage and calcifications were detected. No intratumoral fatty component was detected.

Conclusion: CT findings of adrenal pheochromocytoma were typical heterogeneous soft tissue density mass and moderate enhancement. Tumors with cystic component and hemorrhage were common in our study. CT was useful for tumor characterization in patient with nonclassic clinical manifestation of pheochromocytoma and also for pre-operative management.