Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis
An adrenal “incidentaloma” is defined as an unexpected finding on radiological imaging performed for unrelated indications. Improvements in radiological technology have seen a dramatic increase in this phenomenon. We report the unique case of a 60-year-old female presenting with a 6-month history of...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2014/645462 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561208559927296 |
|---|---|
| author | M. R. Boland A. J. Lowery S. Walsh D. Beddy R. S. Prichard D. O’Shea S. J. Skehan E. W. McDermott |
| author_facet | M. R. Boland A. J. Lowery S. Walsh D. Beddy R. S. Prichard D. O’Shea S. J. Skehan E. W. McDermott |
| author_sort | M. R. Boland |
| collection | DOAJ |
| description | An adrenal “incidentaloma” is defined as an unexpected finding on radiological imaging performed for unrelated indications. Improvements in radiological technology have seen a dramatic increase in this phenomenon. We report the unique case of a 60-year-old female presenting with a 6-month history of abdominal pain, altered bowel habit, and rectal bleeding. Her past medical history included situs inversus totalis and a patent ductus arteriosus. Colonoscopy revealed an ulcerated tumour in her sigmoid colon. Staging PET-CT confirmed a sigmoid tumour and also identified a large heterogenous enhancing FDG-avid right adrenal mass. Biochemical testing/MIBG imaging confirmed a right adrenal phaeochromocytoma. Hypertension was controlled and excision was performed via a transperitoneal laparoscopic adrenalectomy, in the left lateral decubitus position. Uniquely, liver retraction was not required due to its position in the left hypochondrium. Histology confirmed a benign 46 mm phaeochromocytoma. Subsequent uncomplicated sigmoid colectomy/right salpingo-oophorectomy for a locally advanced colonic tumour was performed with adjuvant chemotherapy. This case highlights the importance of accurately identifying functioning adrenal tumours before elective surgery as undiagnosed phaeochromocytomas carry significant intraoperative morbidity/mortality. Right adrenalectomy was made easier in this patient by the liver’s unique position. Uncomplicated colorectal resection was made possible by combined preoperative functional/anatomical imaging. |
| format | Article |
| id | doaj-art-2ec413a02b4b4523aab713eba787ae22 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-2ec413a02b4b4523aab713eba787ae222025-02-03T01:25:35ZengWileyCase Reports in Surgery2090-69002090-69192014-01-01201410.1155/2014/645462645462Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis TotalisM. R. Boland0A. J. Lowery1S. Walsh2D. Beddy3R. S. Prichard4D. O’Shea5S. J. Skehan6E. W. McDermott7The Department of Endocrine, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Endocrine, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Endocrine, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Colorectal Surgery, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Endocrine, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Endocrinology, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandThe Department of Endocrine, St Vincent’s University Hospital, Elm Park, Dublin 4, IrelandAn adrenal “incidentaloma” is defined as an unexpected finding on radiological imaging performed for unrelated indications. Improvements in radiological technology have seen a dramatic increase in this phenomenon. We report the unique case of a 60-year-old female presenting with a 6-month history of abdominal pain, altered bowel habit, and rectal bleeding. Her past medical history included situs inversus totalis and a patent ductus arteriosus. Colonoscopy revealed an ulcerated tumour in her sigmoid colon. Staging PET-CT confirmed a sigmoid tumour and also identified a large heterogenous enhancing FDG-avid right adrenal mass. Biochemical testing/MIBG imaging confirmed a right adrenal phaeochromocytoma. Hypertension was controlled and excision was performed via a transperitoneal laparoscopic adrenalectomy, in the left lateral decubitus position. Uniquely, liver retraction was not required due to its position in the left hypochondrium. Histology confirmed a benign 46 mm phaeochromocytoma. Subsequent uncomplicated sigmoid colectomy/right salpingo-oophorectomy for a locally advanced colonic tumour was performed with adjuvant chemotherapy. This case highlights the importance of accurately identifying functioning adrenal tumours before elective surgery as undiagnosed phaeochromocytomas carry significant intraoperative morbidity/mortality. Right adrenalectomy was made easier in this patient by the liver’s unique position. Uncomplicated colorectal resection was made possible by combined preoperative functional/anatomical imaging.http://dx.doi.org/10.1155/2014/645462 |
| spellingShingle | M. R. Boland A. J. Lowery S. Walsh D. Beddy R. S. Prichard D. O’Shea S. J. Skehan E. W. McDermott Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis Case Reports in Surgery |
| title | Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis |
| title_full | Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis |
| title_fullStr | Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis |
| title_full_unstemmed | Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis |
| title_short | Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis |
| title_sort | incidental phaeochromocytoma on staging pet ct in a patient with a sigmoid tumour and situs inversalis totalis |
| url | http://dx.doi.org/10.1155/2014/645462 |
| work_keys_str_mv | AT mrboland incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT ajlowery incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT swalsh incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT dbeddy incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT rsprichard incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT doshea incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT sjskehan incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis AT ewmcdermott incidentalphaeochromocytomaonstagingpetctinapatientwithasigmoidtumourandsitusinversalistotalis |