Journal List > J Korean Endocr Soc > v.24(3) > 1003498

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Park, Kim, Roh, Song, Jung, Jung, Park, Kim, Mok, Kim, Kim, Kim, Byun, Suh, and Yoo: A Case of Improved Diabetes Mellitus After Removal of Nonfunctioning Adrenal Incidentaloma Diagnosed as Pheochromocytoma
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2009; 24(3): 189-194.

Published online: 30 September 2009

DOI: https://doi.org/10.3803/jkes.2009.24.3.189

A Case of Improved Diabetes Mellitus After Removal of Nonfunctioning Adrenal Incidentaloma Diagnosed as Pheochromocytoma

Se Kyung Park, Duk Su Kim, Mi Oh Roh, Min Soo Song, Chan Hee Jung, Jung Hwa Jung, Hyeong Kyu Park, Yeo Ju Kim, Ji Oh Mok, Sang Jin Kim, Chul Hee Kim, Dong Won Kim1, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo

Department of Internal Medicine, Soonchunhyang University College of Medicine, Korea.

1Department of Pathology, Soonchunhyang University College of Medicine, Korea.

Received 24 November 2008       Accepted 13 June 2009

Copyright © 2009 Korean Endocrine Society

Abstract

Pheochromocytoma not only decreases insulin secretion but also increases insulin resistance. One third of patients with pheochromocytoma have diabetes mellitus and their clinical prognosis showed improvement after surgery. Until now, those patients whose prognosis for diabetes mellitus improved after the operation of pheochromocytoma had typical characteristics such as hypertension, palpitation, headache and elevated hormones such as Vanillylmandelic acid, metanephrine, epinephrine and norepinephrine. We present the case of a 75-year-old woman with asymptomatic adrenal incidentaloma identified as pheochromocytoma which exhibited normal biochemical test results, and after removal of the abdominal mass, her severe hyperglycemia improved.

Keywords: diabetes mellitus, nonfunctioning incidentaloma, pheochromocytoma

Figures and Tables

Fig. 1
Enhanced abdomen CT. A. Precontrast axial CT scan shows 4.7 × 4 cm sized well defined heterogeneous low density mass in right adrenal gland (arrow). B. In arterial phase, the mass is well enhanced and has central necrosis (arrow).
jkes-24-189-g001
Fig. 2
Histology findings. A. Cross section of the tumor shows a markedly variegated appearance with focal cystic change and hemorrhage. The tumor is encapsulated. B. On lower magnification, the tumor shows a solid growth pattern with a rich vascular network (×12.5, H&E stain). C. The tumor shows a small nesting pattern of growth with a 'zellballen' appearance (×400, H&E stain). D. Immunohistochemical staining of the tumor cells reveal diffuse and strong positivity for chromogranin (×200).
jkes-24-189-g002
Table 1
24 hr urine catecholamine of preoperation & postoperation
jkes-24-189-i001

VMA, vanillylmandelic acid.

Table 2
Serum Insulin and C-peptide level of preoperation & postoperation
jkes-24-189-i002

FB, fasting blood; 2PPB, 2hours post prandial blood.

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ORCID iDs

Chan Hee Jung
https://orcid.org/http://orcid.org/0000-0001-8988-0187

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