Journal of Ultrasound in Medicine, Vol 13, Issue 7 517-521, Copyright © 1994 by American Institute of Ultrasound in Medicine
Adrenal pheochromocytomas: a broad spectrum of sonographic presentation
W. B. Schwerk, C. Gorg, K. Gorg and I. K. Restrepo
Department of Internal Medicine, Philipps University, Marburg, Germany.
Sonographic findings in 19 patients with proved adrenal pheochromocytomas
observed over a 10 year period were evaluated retrospectively. Adrenal
tumors were analyzed by number, size, echogenicity, internal echogenicity,
and biologic behavior. There were 16 benign and 3 malignant
pheochromocytomas, all of which were well marginated or encapsulated and
ranged from 1.4 to 11 cm in greatest diameter (mean, 4.8 +/- 2.2 cm). A
broad spectrum of sonographic appearances has been noted, including purely
solid tumors (68%), complex masses (16%), and cystic lesions (16%).
Compared with renal parenchyma as a reference tissue, 10 (77%) of 13 solid
pheochromocytomas were isoechoic or hypoechoic, whereas three (23%) were
hyperechoic. Six (46%) of the solid tumors were homogeneously echogenic,
and seven (54%) were heterogeneous. Ultrasonic discrimination between
benign and malignant pheochromocytoma on the basis of acoustic features
alone has proved impossible. Abdominal sonography, however, provided
evidence of malignancy in all three patients with malignant tumors by
disclosing regional or distant metastases. In conclusion, rather than
showing a specific uniform ultrasonographic appearance, pheochromocytoma is
associated with a broad spectrum of possible sonographic presentations.
