Carcinoma of the Adrenal Cortex Presenting as a Pheochromocytoma: Report of a Case

Abstract

A male, aged 44, presented with paroxysmal hypertension and sweating. In the hospital, blood pressure varied from 140/90 to 210/150 mm Hg. Urine catecholamines were increased up to 700 μg/24 hr and VMA (4-hydroxy-3-methoxymandelic acid) to 9 mg/24 hr. There was also hypokalemic alkalosis, and urine 17-OH corticosteroids were 40 mg/24 hr. A malignant tumor of the left adrenal was present, and during operation hypertension increased and required continuous phentolamine to control it. After removal of the tumor, norepinephrine was required for several days to maintain blood pressure. Catecholamines (200 μg/g of tissue) were extracted from the tumor, though this had the histologic appearance of a cortical tumor and subsequent autopsy revealed atrophy of the opposite adrenal cortex.