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.
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](/upload/SynapseData/ArticleImage/0008jkes/jkes-24-189-g001.jpg)
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](/upload/SynapseData/ArticleImage/0008jkes/jkes-24-189-g002.jpg)
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