Abstract
Adrenal gland masses could be classified into functional, malignant, or benign. An adrenal cortical adenoma is one of the most common incidentalomas found with either functional or non-functional type. Pheochromocytoma is a neural crest cell origin tumor associated with catecholamine production. A classic triad of headache, sudden episodic perspiration, and tachycardia marked a pheochromocytoma. We report three patients with adrenal tumors. First, a 52-year-old woman with complaints of pain in the left flank suggests a left kidney tumor. The patient has an increased blood pressure intraoperatively. Adrenal cortical adenoma was found postoperatively. The second case is an Indonesian male 27-year-old with pain in the upper right abdomen. Intraoperative, the patient also has an escalation in blood pressure. Antihypertensive drugs are also used in this patient. Postoperatively, a pathology result of pheochromocytoma was revealed from this patient. The third case, adrenal myelolipoma, was suspected in a 48-year-old male and underwent surgery because of tumor growth. Later, a histopathological examination revealed myelolipoma of the adrenal. Management of adrenal tumor should be done individually based on each patient. In the first and second cases, blood pressure was unstable intraoperatively and was managed using several drugs, and was stable at follow-up. In the third case was no hemodynamic problem. In the case of an adrenal tumor, management tailoring should be based on the individual patient.
Highlights
Adrenal gland masses could be classified into functional, malignant, or benign
Adrenal tumor sometimes found as an incidentaloma, which means the tumor more than 1 cm in size was found during an imaging study with indications other than the adrenal condition, but this excludes the patients who were done an imaging study during cancer work-up
We found a mass from the suprarenal organ, suggestive of an adrenal tumor as a conclusion (Figure 1)
Summary
We reported two cases of adrenal tumors, with one case of adrenal cortical adenoma and one case of pheochromocytoma. Our patient has normal blood pressure without headache, perspiration, or even tachycardia This might be similar to a study from Adler et al They said as many as 20% of pheochromocytoma patients could present with no symptom at all.[23] Intraoperatively, both of our cases showed similar symptoms with a spike in blood pressure. This manifestation has been reported by Kakoki et al.[24] after the adrenalectomy procedure, the patients did not sustain any elevated blood pressure. The management is based on the size and the symptoms of the tumor.[28]
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