General Pathology Catalogue

Browse the catalogue again »

Topography: Morphology:


CASE DETAIL


General Pathology  »   ADRENAL GLANDS (XXIII)  »   Neoplasms (iii)

PHAEOCHROMOCYTOMA

Museum No: XXIII:iii:15   

Year: 1956

 

Click thumbnails below for enlargements


Clinical data:

No clinical details are available on this patient.

Macroscopy:

The adrenalectomy specimen shows a well-defined mass in the medulla, with the cortex appearing as a thin rim of yellowish tissue on the periphery. The mass was soft and friable in consistency, and likely bled easily during the surgery due to increased vascularity.

 

Comments:

Because phaeochromocytomas are very uncommon tumours it is not cost-effective to screen every hypertensive patient, but when screening is indicated, the test(s) must be very sensitive so as not to miss a case. The high sensitivity this will obviously result in more false positives than true positives. [It is vital also to take cognisance of the host of drugs that interfere with the test, at either the physiological or analytical level]. The quoted author nicely outlines the rationale for using a fractionated 24hr urine collection and measuring total metadrenalines (metadrenalin, normetadrenalin and methoxytyramine) rather than the traditional vanillylmandelic acid measurement. Only when a “positive” is obtained with this methodology should one then resort to very expensive imaging studies.

Reference
Barron J. Phaeochromocytoma: diagnostic challenges for biochemical screening and diagnosis. J Clin Pathol. 2010. 63:669-74.