An adrenal pheochromocytoma can be suspected as the cause of an adrenal mass based on its imaging features.



(1) typically > 3.0 cm in diameter

(2) slowly enlarging (<= 1.0 cm per year)


Shape: oval to round with clear margins


Imaging features of an adrenal pheochromocytoma:

(1) heterogenous texture with cystic areas

(2) attenuation (density) on unenhanced CT is usually > 25 Hounsfield units (almost all have a density > 10 HU)

(3) usually vascular

(4) washout of contrast material is < 50% at 10 minutes

(5) T2-weighted MRI images are markedly hyperintense in relation to the liver

(6) necrosis and hemorrhage are common

(7) calcifications may be present, especially in symptomatic tumors


The diagnosis is supported if the patient has typical clinical findings (hypertension, palpitations, headache, sweating, etc).


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