title: Carcinoma-like nonfunctional pheochromocytoma in the right adrenal gland: A case report.
abstract: Evaluation of the malignant potential of a pheochromocytoma (PCC) remains controversial. PCC is regarded as a neuroendocrine tumor (NET), and the classification of NETs has gradually been defined over the last decade, particularly for gastroenteropancreatic NET. The present study describes a case of locally advanced, carcinoma-like, nonfunctional PCC, which may be regarded as neuroendocrine carcinoma (NEC) rather than a malignant PCC. A 72-year-old man was referred to Saitama Red Cross Hospital (Saitama, Japan), presenting with a 2-month history of right flank pain. Computed tomography revealed a right adrenal gland tumor, which measured 6.0 cm in diameter, invading the hilum of the right kidney, liver and inferior vena cava (IVC). Radical surgery was performed with en bloc resection of the right kidney, and adjacent parts of the liver and IVC. Immunohistochemical examination demonstrated that all of the resected tissues were positive for cytokeratin AE1/AE3, chromogranin A, synaptophysin, cluster of differentiation 56 and Ki-67, and the specimen had a Ki-67 index of 80%. A diagnosis of carcinoma-like PCC or NEC of the adrenal gland was confirmed. Reports of NEC of the adrenal gland are extremely rare in the literature, and classification of PCC as a NET has not yet been fully discussed. The present case may therefore contribute to the classification of NETs in the adrenal gland.
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Moriyama
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Takeshita
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Araki
authors.affiliation: Department of Pathology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Takuo
authors.initials: T
authors.lastname: Tokairin
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kagawa
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Pathology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Adachi
authors.affiliation: Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Noro
keywords: Ki-67; adrenal gland neoplasms; malignant pheochromocytoma; neuroendocrine carcinoma; neuroendocrine tumor; pheochromocytoma