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

Mixed Corticomedullary Tumor of the Adrenal Gland: A Case Report and Literature Review

“…As the two components of the adrenal gland have different embryological origins, it is not surprising that mixed corticomedullary tumors are rare. A total of twenty eight patients with adrenal mixed corticomedullary tumors have been described [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Of these, only three had malignant mixed corticomedullary tumors [ 16 , 23 , 24 ] and one [ 16 ] among those succumbed rapidly to their disease.…”

“…Thus, noradrenergic tumors often continuously release norepinephrine while adrenergic (epinephrine predominant) tumors more often release epinephrine in paroxysms. Clinical presentations of mixed corticomedullary tumors have varied from subclinical to florid Cushing’s syndrome [ 3 , 9 , 13 , 17 , 19 , 20 , 22 ], hypertension [ 2 , 3 , 9 , 10 , 13 , 19 , 20 , 21 , 23 , 24 , 26 ] and diabetes [ 2 , 3 , 13 , 21 ] to psychic irritability [ 3 , 19 ] and weight loss [ 2 , 3 , 23 ]. There is clearly a female preponderance, as is illustrated in Table 1 .…”

Adrenal adenoma associated with raised metanephrine level: A case report

“…Those tumors have an ACTH or cortisol-secreting adrenal adenoma in the adrenal cortex and pheochromocytoma or medullary hyperplasia in the medulla of the ipsilateral or contralateral gland. All of them are associated with raised cortisol and catecholamines/metanephrine [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ].…”

“…The functional tumors may manifest as Cushing syndrome due to Adrenocorticotrophic hormone (ACTH) independent or dependent hypersecretion of cortisol [ [1] , [2] , [3] ]. Rarely, they are associated with high levels of metanephrine due to co-existing pheochromocytomas either in the ipsilateral or contralateral adrenal gland [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Pheochromocytomas are rare neuroendocrine tumors that arise from sympathetic adrenomedullary chromaffin tissue, and present with variable symptoms depending on the amount of catecholamine secretion [ 4 ].…”

Editorial for January/February Issue of AACE Clinical Case Reports

“…We also have some interesting adrenal cases suggesting the occurrence of adrenal liposarcoma as part of Multiple Endocrine Neoplasia Type 1, 3 presentation of Adrenal Corticomedullary Mixed Tumor 4 and histopathologic differences between adrenocorticotropic hormone dependent and adrenocorticotropic hormone independent adrenal hyperplasia causing Cushing Syndrome, 5 and primary adrenal insufficiency due to bilateral primary adrenal lymphoma (PAL). 6 …”