Indian Journal of Pathology and Microbiology (Jan 2018)

Adrenal medullary hyperplasia with coexistent cerebral angiomas

  • Latika Gupta,
  • Anusha S Bhatt,
  • Varuna Mallya,
  • Nita Khurana,
  • Pawanindra Lal

DOI
https://doi.org/10.4103/ijpm.ijpm_707_17
Journal volume & issue
Vol. 61, no. 4
pp. 587 – 589

Abstract

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Sporadic adrenal medullary hyperplasia (AMH) is a rare entity and mimics pheochromocytoma clinically as well as pharmacologically. It is characterized by increase in adrenal medullary cells with the expansion of cells into areas normally not seen. A 59-year-old male presented with chronic hypertension and raised 24-h urinary normetanephrine levels. Radiological and clinical possibility of pheochromocytoma led to left transperitoneal laparoscopic adrenalectomy. Histopathology, however, showed increase in adrenal medullary to cortical ratio, further confirmed by immunohistochemistry. The absence of any well-defined lesion led to the diagnosis of AMH. Furthermore, on routine imaging, two asymptomatic cavernous hemangiomas were seen. We present this case to reiterate that AMH is an entity which should be considered as a differential for pheochromocytoma. Furthermore, the presence of asymptomatic cavernous hemangiomas in the cerebrum, in this case, makes it rarer since this sporadic association is seldom seen.

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