Abstract
A 62-year-old woman with umbilical hernia had been incidentally pointed out a left adrenal tumor by a CT scan in 1988, when only repair of the hernia had been performed. Thereafter she was followed in the outpatient clinic. In 1997, she developed diabetes mellitus and hypertension. In November 1997, she complained of abdominal pain and was diagnosed as having relapse of umbilical hernia and a left adrenal tumor again. As serum noradrenalin and urinary normetanephlin levels were high, functional adrenal tumor was selected. However, there was no abnormality in MIBG-scintigraphy nor growing tendency in size in CT and MRI examinations. So a repair of the hernia preceded to other treatments. In April 1999, all levels of serum catecholamines and their urinary metabolites became high and the patient was definitely diagnosed as having pheochromocytoma. A laparoscopic left adrenalectomy was successfully performed. The tumor was wellcapsulated and 2.4×2.3×1.6cm in size. Pathological diagnosis was also pheochromocytoma. In conclusion, the assay for urinary metabolites of catecholamines is advantageous in screening of adrenal incidentaloma.
