Phaeochromocytoma without hypertension

A 34 year old woman presented with a 10 week history of paroxysmal attacks of headache associated with vomiting, sweating,and palpitations. Her blood pressure always remained normal during these episodes. A 24 hour urine collection showed a mildly elevated level of adrenaline at 180 nmol/24hr (normal < 140nmol/24hr) with normal levels of noradrenaline and dopamine. Abdominal computed tomography (CT) showed the following abnormality (see figure). Abdominal computed tomography scan showing a cystic lesion arising from the right adrenal gland impinging on the liver capsule and the inferior vena cava 1. What abnormality is seen on the scan? 2. What is the likely diagnosis? 1. A cystic adrenal tumour. 2. Adrenal phaeochromocytoma. Phaeochromocytoma is an uncommon tumour with an incidence estimated at 0.8 per 100 000 person years. It is associated with a variety of symptoms …