A case of extraadrenal pheochromocytoma associated with adrenal cortical nodular hyperplasia and papillary thyroid carcinoma

A 64-year-old woman was admitted in November, 1996 for fluctuating blood pr essure. There was multinodular goiter in her neck. High urine VMA and serum aldosterone were noted. Computed tomography showed an oval lesion in the l eft adrenal gland. 'Left adrenalectomy was performed and the pathology was proved to be adrenal cortical nodular hyperplasia. Fluctuating blood pressu re and high urine VMA persisted after the operation. CT scan of the abdomen revealed a soft tissue mass in lower abdomen. The patient was admitted aga in in September, 1997. Laboratory examinations showed normal serum aldoster one, normal plasma renin activity and high urine VMA. Aspiration cytology o f the thyroid gland disclosed papillary thyroid carcinoma. [I-131]-metaiodo benzylguanidine image revealed a high uptake lesion in the right L-3 parave rtebral area. Tumor excision and thyroidectomy were performed. The patholog y was reported as extraadrenal pheochromocytoma and papillary thyroid carci noma. Papillary thyroid carcinoma is rarely associated with pheochromocytom a. To our knowledge, this paper is the first report of a patient with extra adrenal pheochromocytoma associated with papillary thyroid carcinoma and ad renal cortical nodular hyperplasia.