A Rare Case: Adrenal Corticomedullary Mixed Tumor With Elements of Pheochromocytoma, Cortical Adenoma, and Ganglioneuroma Cells

罕见病例:肾上腺皮质髓质混合瘤,包含嗜铬细胞瘤、皮质腺瘤和神经节瘤细胞成分

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Abstract

BACKGROUND/OBJECTIVE: Adrenal corticomedullary mixed tumor (CMMT) are extremely rare single adrenal tumor masses containing a mixture of adrenal cortical adenoma and pheochromocytoma cells. CASE REPORT: A 52-year-old woman presented with clinical and biochemical evidence of cortisol and catecholamine excess and was found to have an adrenal CMMT with intermixed chromaffin, cortical adenoma, and ganglioneuroma components. She underwent a successful unilateral adrenalectomy with subsequent improvement in her symptoms. DISCUSSION: We report the first case of a patient with a CMMT that had symptoms of both catecholamine and cortisol excess from her tumor. Typically, patients with similar tumors have signs of cortisol excess; however, the pheochromocytoma portion is clinically silent. Although most CMMT contain 2 distinct cell types, this is the third ever described case of a single adrenal CMMT containing 3 unique cellular components: (1) intermixed chromaffin, (2) cortical adenoma, and (3) ganglioneuroma cells. CONCLUSION: Our understanding of these rare tumors is limited, and this case serves to broaden our knowledge about their clinical, biochemical, and pathologic features.

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