Adrenal Lymphangioma Masquerading as a Catecholamine Producing TumorReport as inadecuate

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Case Reports in Endocrinology - Volume 2015 2015, Article ID 380151, 4 pages -

Case Report

Division of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109, USA

Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA

Corcept Therapeutics, Menlo Park, CA 94025, USA

Received 6 August 2015; Accepted 21 October 2015

Academic Editor: Takeshi Usui

Copyright © 2015 Israel Hodish et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To report the unusual case of an adrenal lymphangioma presenting in a patientwith an adrenal cystic lesion and biochemical testing concerning for pheochromocytoma. The pertinent diagnostic and imaging features of adrenal lymphangiomas are reviewed. Methods. We describe a 59-year-old patient who presented with hyperhidrosis and a 2.2 by 2.2 cm left adrenal nodule. Biochemical evaluation revealed elevated plasma-free normetanephrine, urine normetanephrine, urine vanillylmandelic acid, and urine norepinephrine levels. Elevated plasma norepinephrine levels were not suppressed appropriately with clonidine administration. Results. Given persistent concern for pheochromocytoma, the patient underwent adrenalectomy. The final pathology was consistent with adrenal lymphangioma. Conclusions. Lymphangiomas are benign vascular lesions that can very rarely occur in the adrenal gland. Imaging findings are generally consistent with a cyst but are nonspecific. Excluding malignancy in patients presenting with adrenal cysts can be difficult. Despite its benign nature, the diagnosis of adrenal lymphangioma may ultimately require pathology.

Author: Israel Hodish, Lindsay Schmidt, and Andreas G. Moraitis



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