Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis.

[adrenal incidentaloma]

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 â€‰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 .

Diseases
Validation

Diseases presenting "abdominal pain" symptom

22q11.2 deletion syndrome

adrenal incidentaloma

alpha-thalassemia

benign recurrent intrahepatic cholestasis

carcinoma of the gallbladder

child syndrome

cholangiocarcinoma

congenital diaphragmatic hernia

cushing syndrome

cutaneous mastocytosis

cystinuria

dedifferentiated liposarcoma

erdheim-chester disease

erythropoietic protoporphyria

fabry disease

familial hypocalciuric hypercalcemia

familial mediterranean fever

focal myositis

liposarcoma

lymphangioleiomyomatosis

malignant atrophic papulosis

pleomorphic liposarcoma

primary effusion lymphoma

primary hyperoxaluria type 1

proteus syndrome

scrub typhus

sneddon syndrome

systemic capillary leak syndrome

typhoid

von hippel-lindau disease

well-differentiated liposarcoma

This symptom has already been validated