title: Composite pheochromocytoma of the adrenal gland: a case series.
abstract: BACKGROUND
  Composite pheochromocytoma is a rare pathological condition characterized by elements of both pheochromocytoma and neurogenic tumors. However, detailed clinical outcomes of this tumor have not been fully shown. From 2007 to 2013, we experienced three cases of adrenal composite pheochromocytoma. In this report, we investigate the clinicopathological features of these three cases of composite pheochromocytoma and compare them with previously reported cases.
  
  
  METHODS
  Cases 1 and 2 were a 29-year-old Japanese woman and a 59-year-old Japanese man, respectively. They underwent laparoscopic left adrenalectomy, and pathological examination revealed composite pheochromocytoma-ganglioneuroma. Case 3 was a 53-year-old Japanese man who had been receiving hemodialysis for 17 years. He underwent laparoscopic right adrenalectomy, and pathological examination revealed composite pheochromocytoma-ganglioneuroblastoma. Although the Ki67-positive rates varied from 1.0 to 6.2% among the three cases, no clinical recurrences occurred. Despite the relatively high rate of Ki67 positivity, complete tumor resection resulted in favorable clinical outcomes.
  
  
  CONCLUSIONS
  We experienced three cases of adrenal composite pheochromocytoma. Although the clinical findings and treatment outcomes of composite pheochromocytoma were similar to those of ordinary pheochromocytoma, further studies of the biological behavior and genetic profiles of composite pheochromocytoma are necessary to achieve a better understanding of this tumor.
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. yshida.urodr@gmail.com.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Shida
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. tigawa@nagasaki-u.ac.jp.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Igawa
authors.affiliation: Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. abek@nagasaki-u.ac.jp.
authors.forename: Kuniko
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. erbb2jp@yahoo.co.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hakariya
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. takehara@nagasaki-u.ac.jp.
authors.forename: Kousuke
authors.initials: K
authors.lastname: Takehara
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. oonitat@nmc.hosp.go.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Onita
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. hsakai@nagasaki-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics*; D005260:Female; D018305:Ganglioneuroblastoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005729:Ganglioneuroma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D015870:Gene Expression; D006801:Humans; D019394:Ki-67 Antigen / Q000235:genetics*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen