World Journal of Endocrine Surgery

Register      Login

VOLUME 15 , ISSUE 1 ( January-April, 2023 ) > List of Articles


Clinically Silent Behavior in a Giant Pheochromocytoma with Malignant Potential: A Case Report

Tanvi Vijay, Manoj Andley, Gyan Saurabh, Anita Nangia

Keywords : Case Report, Asymptomatic pheochromocytoma, Giant pheochromocytoma, Inert pheochromocytoma, Malignant pheochromocytoma, Nonsecretory pheochromocytoma, Silent pheochromocytoma

Citation Information : Vijay T, Andley M, Saurabh G, Nangia A. Clinically Silent Behavior in a Giant Pheochromocytoma with Malignant Potential: A Case Report. World J Endoc Surg 2023; 15 (1):14-17.

DOI: 10.5005/jp-journals-10002-1445

License: CC BY-NC 4.0

Published Online: 31-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: This case report aims to highlight the behavior of pheochromocytoma (PCC) based on its size and its malignant potential. Background: Pheochromocytomas (PCCs) are rare catecholamine-secreting tumors of the chromaffin cells of the adrenal medulla or paraganglia at other places. They usually present with a symptom triad of headache, palpitations and sweating with paroxysmal hypertension. There are also those which are asymptomatic, termed as silent/nonsecretory/nonfunctional/unsuspected. Roughly 10% are malignant in nature. Case description: We report the case of a 33-year-old male who presented with complaints of mass over the left side of the abdomen for 2 weeks which was not noticed before and is nonprogressive. Abdominal examination revealed a large retroperitoneal lump measuring 10 × 10 cm in the left hypochondrium. Contrast computerized tomography (CT) abdomen revealed a suprarenal heterogeneous mass likely arising from the adrenal glands with normal biochemical workup. He was operated on, and the mass was removed with the postoperative report suggestive of PCC with malignant potential with a PCC of the Adrenal gland Scaled Score (PASS) score of 8/10. Conclusion: This was a case of a large PCC that was nonsecretory, and usually, PCC secretory behavior correlates well with size.2 Clinical significance: Our case highlights one of the rarer cases of a borderline PCC which was nonsecretory despite its large size.

  1. Spiro A, Usman A, Ajmal A, et al. Asymptomatic and biochemically silent pheochromocytoma with characteristic findings on imaging. Case Rep Endocrinol 2020;2020:8847261. DOI: 10.1155/2020/8847261
  2. Lal G, Clark OH. Thyroid, parathyroid and adrenal. In: Roses RE, Dempsey DT, editors. Stomach. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Kao LS, Hunter JG, Matthews JB, Pollock RE, editors. Schwartz's Principles of Surgery. 11th ed. New York: McGraw-Hill; 2019. pp. 929–946.
  3. Mannelli M, Lenders JW, Pacak K, et al. Subclinical phaeochromocytoma. Best Pract Res Clin Endocrinol Metab 2012;26(4):507–515. DOI: 10.1016/j.beem.2011.10.008
  4. Chatzellis E, Kaltsas G. Adrenal Incidentalomas. [Updated 2019 Nov 7]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc. 2000. Available from:
  5. Michael J. Stechman and DavidM. Scott-Coombes. The adrenal glands and other abdominal endocrine disorders. In: O’Connell PR, McCaskie AW, Sayers RD, editors. Bailey & Love's Short Practice of Surgery. CRC Press; 2023 Mar 30. DOI: 10.1201/9781003106852
  6. Park GE, Cho YY, Hong YS, et al. A functioning adrenal adenoma and pheochromocytoma in the same adrenal gland: two discrete adrenal incidentalomas. Korean J Intern Med 2015;30(1):114–117. DOI: 10.3904/kjim.2015.30.1.114
  7. Lui SA, Oh HB, Tan KB, et al. Clinical challenges in nonfunctional pheochromocytomas. World J Endoc Surg 2019;11(3):86–90. DOI: 10.5005/jp-journals-10002-1264
  8. Khadilkar K, Sarathi V, Kasaliwal R, et al. Predictors of malignancy in patients with pheochromocytomas/paragangliomas: Asian Indian experience. Endocr Connect 2016;5(6):89–97. DOI: 10.1530/EC-16-0086
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.